Why Cost Is a Barrier to Emergency Contraception Access

For many patients, the cost of emergency contraception can be a significant barrier — especially when they need it most. While Afterpill (Levonorgestrel 1.5 mg) is one of the more affordable options on the market, patients who don't know about savings programs or insurance coverage strategies may pay more than necessary, or worse, forgo emergency contraception entirely because of cost concerns.

As a healthcare provider, you're in a unique position to help patients navigate these options. This guide covers every major savings strategy for Afterpill and Levonorgestrel emergency contraceptives, so you can counsel patients effectively and ensure cost doesn't stand between them and timely access.

Understanding Afterpill's Pricing Landscape

Before diving into savings strategies, here's the current pricing context:

• Afterpill (AfterPill.com): ~$20 + $5 shipping — the most affordable branded option, sold as advance provision through their website
• Generic Levonorgestrel 1.5 mg at retail pharmacies: $10–$45 depending on brand and retailer
• Plan B One-Step (brand): $40–$50 at most pharmacies
• With insurance + prescription: $0 under most ACA-compliant plans

The wide price range creates an opportunity for informed providers to guide patients toward the most cost-effective option for their situation.

Strategy 1: Write a Prescription for Insurance Coverage

This is the single most impactful thing you can do to reduce your patient's cost.

Under the Affordable Care Act (ACA), most health insurance plans must cover FDA-approved emergency contraceptives without cost-sharing when obtained with a prescription. This means the patient pays $0.

Key points for prescribers:

• Even though Levonorgestrel is available OTC, a prescription triggers the ACA preventive coverage mandate
• Write the prescription for "Levonorgestrel 1.5 mg tablet" to allow generic dispensing at the lowest cost
• Consider writing for multiple fills or advance provision so patients can have it on hand
• Some insurance plans may require prior authorization — if so, provide supporting documentation
• Medicaid coverage varies by state; check your state's Medicaid formulary

Pro tip: Educate patients that even if they don't need emergency contraception today, having a prescription on file means they can fill it quickly and at no cost if the need arises.

Strategy 2: Recommend AfterPill.com for Advance Provision

For patients without insurance or those who want emergency contraception on hand, recommend ordering from AfterPill.com:

• Cost: ~$20 + $5 shipping
• Model: "Buy it before you need it" — shipped directly to their home
• Privacy: Discreet packaging
• No prescription or ID needed

This is particularly useful for patients in areas with limited pharmacy access or those who may face stigma purchasing emergency contraception in person. Advance provision has been shown in studies to improve timely use without increasing risk-taking behavior.

Strategy 3: Direct Patients to Low-Cost Pharmacy Options

Different pharmacies charge significantly different prices for the same Levonorgestrel product. Help patients find the best price:

• Walmart and Sam's Club: Often among the lowest retail prices for generic Levonorgestrel
• Costco: Competitive pricing, and you don't need a membership to use the pharmacy
• Amazon Pharmacy: Online ordering with potential Prime discounts
• Dollar stores and discount retailers: Some carry emergency contraception at lower prices

Encourage patients to use MedFinder for Providers to help locate the most affordable options in their area.

Strategy 4: Coupon and Discount Card Programs

Free prescription discount cards can reduce costs for patients paying out of pocket. These work even without insurance:

• GoodRx: Widely used discount card that can significantly reduce the price of Levonorgestrel at participating pharmacies
• SingleCare: Free discount card accepted at most major pharmacy chains
• RxSaver: Compares prices across pharmacies with available coupons
• ScriptSave WellRx: Another free savings card option
• Optum Perks: Digital discount card with pharmacy price comparisons

While these typically require a prescription to apply the discount at the pharmacy, the combined savings can be substantial. For a comprehensive list of savings options, see our patient-facing guide on saving money on Afterpill.

Strategy 5: Connect Patients with Community Resources

For uninsured or underinsured patients, community-based resources can provide free or very low-cost emergency contraception:

Planned Parenthood

Planned Parenthood health centers provide emergency contraception on a sliding fee scale, and many can provide it for free. They are available in most metropolitan areas and many rural communities.

Title X Family Planning Clinics

Federally funded Title X clinics are required to provide family planning services, including emergency contraception, on a sliding fee scale. Patients at or below the federal poverty level receive services for free. Find a clinic through HRSA's locator.

Community Health Centers (FQHCs)

Federally Qualified Health Centers serve patients regardless of ability to pay and offer sliding-scale fees. Many stock emergency contraception.

University and College Health Centers

For student patients, campus health centers often provide emergency contraception at reduced cost or free.

Strategy 6: Leverage Your Prescribing to Maximize Value

How you write the prescription can affect what the patient pays:

• Prescribe generically: Write for "Levonorgestrel 1.5 mg" rather than a specific brand to allow the pharmacy to dispense the cheapest option
• Include DAW-0 (Dispense as Written — substitution allowed): Ensures the pharmacy can substitute generics
• Prescribe for advance provision: Multiple fills allow the patient to have emergency contraception on hand at no cost through insurance
• Document medical necessity: If insurance requires prior authorization, document the clinical rationale to facilitate approval

Strategy 7: Educate About the OTC Landscape

Many patients don't realize that:

• All Levonorgestrel 1.5 mg products are therapeutically equivalent — the cheapest option works the same as the most expensive
• Emergency contraception is available without a prescription or ID to all ages
• Store brands and generics (Take Action, My Way, EContra One-Step) are significantly cheaper than Plan B One-Step
• Afterpill through AfterPill.com is roughly half the cost of Plan B at retail

A brief conversation during a clinical encounter can save patients significant money and reduce barriers to future access.

Special Populations: Tailoring Your Approach

Adolescents

Teens may face unique barriers: lack of insurance knowledge, limited funds, and concerns about confidentiality. Emphasize that no prescription, ID, or parental consent is required for OTC purchase. If they have insurance through a parent's plan, be aware that an explanation of benefits (EOB) may be sent home — discuss this privacy concern and consider recommending cash-pay options like AfterPill.com instead.

Patients on Enzyme-Inducing Medications

Patients on medications like Carbamazepine, Phenytoin, Rifampin, or St. John's Wort may need alternative emergency contraception (copper IUD is most reliable). Factor in the cost of these alternatives when counseling. For detailed interaction information, see our guide on Afterpill drug interactions.

Patients with Higher Body Weight

For patients over 165 lbs, Afterpill's efficacy may be reduced. Ella (Ulipristal Acetate) or the copper IUD may be more appropriate. Ella typically costs $40–$65 but is covered under most insurance with a prescription. The copper IUD is often fully covered by insurance as well.

Addressing Common Provider Questions

"Can I prescribe emergency contraception in advance?"

Yes. Advance provision prescribing is supported by ACOG and other professional organizations. Studies show it increases timely use without increasing sexual risk behavior. This is especially valuable when combined with insurance coverage for zero out-of-pocket cost.

"What if my patient's insurance denies coverage?"

Recommend the patient file an appeal citing the ACA preventive services mandate. In the meantime, direct them to AfterPill.com ($20) or a discount card program. If they need EC immediately, community resources like Planned Parenthood can help.

"Should I recommend Afterpill specifically or any Levonorgestrel EC?"

All Levonorgestrel 1.5 mg products are equivalent. Recommend whatever is most accessible and affordable for the patient. Afterpill is the cheapest if ordering online in advance; at the pharmacy counter, the cheapest generic available is the best choice.

Provider Resources

Bookmark these resources for quick reference:

• MedFinder for Providers — Help patients find medications in stock and at the best price
• HRSA Health Center Locator — Find Title X and FQHC clinics for referrals
• AfterPill.com — Direct patients for affordable advance provision

For more provider-focused resources, see our guides on the Afterpill shortage from a prescriber's perspective and how to help patients find Afterpill in stock.

The Bottom Line

Cost should never prevent a patient from accessing emergency contraception. As a provider, you have powerful tools at your disposal: prescribing for insurance coverage, directing patients to low-cost options like AfterPill.com, connecting them with community resources, and educating them about generic equivalence and discount programs.

A few minutes of counseling can save your patients significant money and — more importantly — ensure they can access emergency contraception when time is critical.

Visit MedFinder for Providers for tools to help your patients find and afford their medications.