Medically reviewed by Sophia Yen, MD, MPH – Written by Pandia Health Editorial Team
Ah, Plan B, the good-ol’ emergency contraception pill. Did you know it’s not the only emergency birth control option or the most effective one? When it comes to emergency birth control, there are a few options (including the copper IUD!)
Pandia Health can prepare you for any “morning after” accidents by shipping you emergency contraception for FREE!
Of course, emergency contraception (EC) should not be a replacement for regular birth control. EC makes you bleed irregularly and is not as effective as non-emergency hormonal birth control. If you ever have a contraceptive accident, here are some key differences between the two standard emergency contraception pill options: Ella and Plan B.
Ella vs Plan B: What’s the difference?
Access
TLDR: Plan B and its generics are over the counter. Ella is only available by prescription.
Plan B is easier to get than Ella. You can get Plan B (and its generics such as MyWay, Afterpill, Econtra EZ, React Levonorgestrel, Opcicon, Athentia Next, Fallback Solo, Next Choice One Dose, Levonorgestrel) from grocery stores or pharmacies without a prescription.
If you’re getting Ella, you’ll need a prescription which you can get through Pandia Health (we include a prescription for it for FREE as part of any birth control consultation) or any prescribing provider (e.g. doctor/NP/PA).
It’s best to think ahead when buying Ella because the process of getting it may take longer. Get it in advance of need. You can get it the next time you see your doctor and keep it stored for any future contraceptive emergencies. (Most of the time you can get Ella with an expiration date 2 yrs from the time you get it.) You can also just call your doctor any time and ask for an “advance prescription” in case of emergencies.
Hormones
Levonorgestrel is a synthetic form of progesterone and is the active ingredient in Plan B and its generics. In birth control, like the hormonal IUDs, levonorgestrel works to prevent the release of an egg; if an egg is already released, Plan B and its generics will most likely not work.
On the other hand, Ella’s active ingredient is ulipristal acetate which is a SPRM selective progesterone receptor modulator. It works by preventing the egg from being released =ovulation.
For both pills, there is no evidence to show any effect once the egg is fertilized.
Timing
TLDR: Ella beats Plan B at every time point and for up to 5 days.
If you choose Plan B as your emergency contraception, it is best to take it within 72 hours (3 days) of having unprotected sex. ella’s time frame is a little longer; studies have shown that it can work for up to 120 hours (5 days) after unprotected sex.
Efficacy
TLDR: if your BMI is 26 or greater, use Ella.
Ella’s efficacy is about 2.5 times higher than Plan B’s during 0-24 hrs after contraceptive failure and ~2x better at 0-72 and 0-120 hrs. This advantage is maintained throughout the 5-day timeframe after unprotected sex. With Ella only 9 out of 1000 women who use it within 24 hrs of contraceptive accident/failure will get pregnant.
Plan B and levonorgestrel EC pills are about 85% effective at preventing pregnancies, but it depends on where in your cycle you take it and how soon after the contraceptive accident/failure you take it.
Best to take any emergency contraception ASAP.
One very important thing to note: Ella is more effective than Plan B and its generics at EVERY BMI. Ella works for people who have BMIs up to 35. If you have a BMI of 26 or more, Plan B and its generics do NOT work so well. If you have a BMI of 30 or more, Plan B and its generics do NOT work at all; instead, use Ella or the copper IUD. If your BMI is 35 or greater, your only option for emergency contraception is the IUD (either the copper IUD or the 52 mg levonorgestrel IUD.
Cost
Under the Affordable Care Act if you have insurance, you should not have to pay any copays for either Ella or Plan B and its generics. If you are having trouble getting it covered, contact CoverHer (a nonprofit program of the National Women’s Law Center) and they can help advocate for you to get it with NO copay and NO deductible.
Without insurance, Ella costs around $44-55 and Plan B is $41-$53 plus tax although its genericscan range from $11-$40.
Because Plan B and its generics are over-the-counter, it may be harder to get these costs covered – which is another great reason to consider going with Ella instead! Note: there are many generic brands of Plan B which are cheaper than Plan B and work just as well!
What’s Similar?
Move Quickly
Although Ella may work for up to 5-days, it is still best to take either it or Plan B and its generics ASAP.
Insurance Coverage
Like mentioned above, Ella and Plan B can both be free of charge if you have insurance and are buying ahead.
The Relief of Having It Around Just in Case
Both Ella and Plan B work to prevent pregnancy BUT they are not as good as non-emergency birth control methods like the IUD, implant, shot, contraceptive ring, contraceptive patch, or birth control pill! If you have a condom break or forget to take your birth control for 3 days in a row, the relief that comes with having this back-up is a welcome side-effect.
Get #PandiaPeaceOfMind by making sure you are covered everyday with regular and more effective birth control and have some emergency contraception around in case you forget to take your regular birth control.
Check out this emergency contraception video featuring our CEO and Co-Founder, Dr. Sophia Yen!
If you want to learn more, check out our blogs on emergency contraception. Remember, Pandia Health can help you get a prescription for ella, and deliver your usual birth control to you, both with FREE delivery! And if you have insurance, “FREE of charge” = no copay, no deductible!
If you want to learn more, check out our blogs on emergency contraception. Remember, Pandia Health can help you get a prescription for Ella, and deliver your usual birth control to you, both with FREE delivery! And if you have insurance, the medication should be “FREE of charge” = no copay, no deductible!
Disclaimer: This article, even if and to the extent that features the advice of physicians and medical practitioners, it is not, nor is it intended to be, a substitute for professional medical advice, diagnosis or treatment, and should never be relied upon for specific medical advice. Always seek the advice of your doctor/primary care provider for specific health needs.
FAQs
What is emergency contraception?
Sometimes, accidents happen. Maybe you forgot to take your regular birth control pill or the condom broke while you were having sex, and now you’re worried about getting pregnant. Luckily, you can prevent pregnancy by taking emergency contraceptive pills, which work by delaying ovulation. These should not be used as a replacement of your usual birth control, because they can cause irregular periods and they are not as effective as non-emergency birth control. A more successful, long-term solution to preventing pregnancy would be getting an IUD or implant or going on the birth control pill, patch or ring. But if you just want a backup, emergency contraception pills are a great option.
How does emergency contraception reduce the risk of pregnancy?
An emergency contraceptive pill (like Ella or Plan-B) prevents pregnancy by delaying ovulation (when the ovary releases an egg). Ella is the most effective emergency contraceptive pill, reducing your chances of getting pregnant to 9 out of 1000 people with uteri if used withing 24 hrs.
How does emergency contraception work?
Most emergency contraceptives should be used as a backup to prevent unwanted pregnancy. Ella and Plan B are the most common forms of emergency contraceptive pills(ECPs), which reduce the risk of pregnancy by preventing ovulation temporarily. They need to be taken within 5 days (but ASAP is best) of unprotected sex or contraceptive failure/accident. Emergency contraceptive pills shouldn’t be taken regularly because they do not work as well as non-emergency birth control options such as the IUD, implant, shot, birth control pills, patch, rings. However, if you want a long-term solution, you should consider getting on regular birth control like the pill, the ring, or the patch. These all use hormones to prevent ovulation and block sperm from getting into the uterus for more effective pregnancy prevention. The pill is taken daily, the ring you can self-insert into the vagina, and the patch is placed on your skin and changed out weekly. And what’s more, whichever one you choose, Pandia’s expert doctors can prescribe it for you!
Where to get emergency contraception?
You can get emergency contraception pills made with levonorgestrel like PlanB or its genericsfrom any drug store without a prescription. But if your BMI is 26 or greater, it’s best to consider Ella instead. Ella is only available with a prescription. If you want to #GetTheGoodStuff, our Co-founder Dr. Sophia Yen recommends Ella because it beats Plan B and its generics at every time point and works up to a BMI of 35. Pandia Health can send Ella or Plan B generics to you in the mail.
How much does emergency contraception cost?
Most health insurance companies are now required by Affordable Care Act to cover all forms of birth control, which include IUDs, the pill/ patch/ ring, and emergency contraceptive pills. With insurance, it should be “free” = no copay, no deductible. Without insurance, the cost of both Ella and PlanB ranges around $55, and generic PlanB options can be as low as $11.
How late does emergency contraception delay period?
Because emergency contraception pills delay ovulation, it can also postpone your menstruation. The delay should only be about a week, so if you still haven’t gotten your period 3-4 weeks later, you may be pregnant and you should take a pregnancy test.