How You Can Access Insurance-Covered Emergency Contraception At Your Pharmacy—Without a Doctor!
October 20, 2022 | Reproductive Equity Now
In the face of nationwide attacks on reproductive health care, Massachusetts is standing up and expanding access to emergency contraception.
In July, the state passed An Act Expanding Protections for Reproductive and Gender-Affirming Care, which included major provisions to make emergency contraception more affordable and accessible across the state. One key provision from that bill was a statewide standing order for emergency contraception. Let’s take a look at what that means:
What is a standing order?
Standing orders are useful public health interventions that authorize pharmacies to dispense medication without a prescription from a provider, making care more accessible and timely.
A statewide standing order for emergency contraception removes barriers and makes it so that patients can go directly to their pharmacy and a pharmacist can dispense Plan B One Step® or ella® after consulting with the patient. A common standing order allows pharmacists to give flu vaccines without needing a prescription from each individual's doctor. Similarly, the widespread roll out of the COVID-19 vaccination was made possible because of a standing order.
Simply, this standing order will give people greater access to time-sensitive and affordable emergency contraception, without the need for a prescription from a doctor.
Why we needed a statewide standing order for emergency contraception:
Typically, in the past, when a person faced contraception failure, they would go to a CVS or Walgreens and buy over-the-counter emergency contraception like Plan B One-Step for upwards of $40, simply because it was the most available option when faced with a time-sensitive situation.
This poses two challenges.
The first: emergency contraception is expensive. While generic versions of Plan B One Step® range from $35-40, the brand name typically costs $50. ella®—which was previously only available with a prescription—typically ranges in cost from $50-$67. While our state law and the Affordable Care Act require insurance to cover emergency contraception with a prescription at no cost, people still buy Plan B One Step® over-the-counter and pay out of pocket because it's easier and quicker than going to a doctor and obtaining a prescription.
The second issue: Plan B One Step® isn’t the most effective form of emergency contraception for every person. If you weigh over 160lbs, Plan B actually becomes less effective, while UPA-based emergency contraception like ella® is effective for people up to 195 pounds. Ella® can also work up to five days after intercourse. ella® is not available over the counter and typically requires a prescription from a doctor. But emergency contraception is time-sensitive, and getting an appointment with a provider to obtain a prescription can be time-consuming.
What we did to remove barriers to emergency contraception:
A key feature of the new statewide emergency contraception standing order is that it allows pharmacists to dispense both LNG-based contraception like Plan B One Step® AND UPA-based emergency contraception like ella®, based on what is best for the patient and without a prescription from a doctor.
That means, a person can walk into any CVS, Walgreens, or any pharmacy across Massachusetts, consult with the pharmacy counter, and access either over-the-counter or prescription emergency contraception through insurance at the point of sale.
This skips the time-consuming process of getting a prescription from a doctor while cutting down on major cost barriers by ensuring insurance covers the cost of the medication. People will now be able to access the medication that is right for them at no cost!
Here’s how you can talk with your pharmacist about the statewide standing order:
"I learned about Massachusetts’ statewide standing order for emergency contraception, which allows me to get the emergency contraception pill, like levonorgestrel (Plan B One-Step®) or ulipristal acetate (ella®), at no cost and without a prescription from my doctor.”
“Can you dispense me emergency contraception? I learned that pharmacists can dispense it without a prescription because of a statewide standing order.”
"I’m covered because of the health insurance plan that I have."
Show them the statewide standing order linked HERE!
Why this is so important:
Emergency contraception gives people the freedom to better decide if and when to start a family. At this moment of national crisis, states must act to pass bold and comprehensive policies to expand access to emergency contraception. That's why Reproductive Equity Now launched a toolkit to help advocates pass statewide standing orders of their own.
Our toolkit analyzes our own advocacy to get the statewide standing order passed and offers recommendations to advocates in other states for best practices when drafting, advocating, and passing legislation of their own. The guide includes communications and advocacy documents that other states can use as templates for their own work.
In a post-Roe America, advocates in blue, purple, and red states must work together, share resources, and learn from one another’s successes to pass bold reproductive health policies. That’s what our toolkit is all about!
