Comparison
Best Online Therapy Platforms in 2026: Tested & Reviewed
Our picks for the best online therapy platforms in 2026, compared on cost, insurance, credentials and fit, with pros, considerations and how we evaluate.
Our top picks
#1
Best for weekly talk therapy
BetterHelp
Adults who want weekly talk therapy with messaging between sessions
Learn more about BetterHelp#2
Best for upfront cash prices
Sesame
Booking a therapist of your choice at an upfront cash price, session by session
Learn more about Sesame#3
Best for insurance coverage
Talkspace
Adults, teens and couples who want to use insurance, including Medicare or TRICARE
Learn more about Talkspace#4
Best for therapy plus a doctor
PlushCare
Insured adults who want therapy and a prescribing doctor in one place
Learn more about PlushCare
The best options, in detail
Best for weekly talk therapy
- Best for: Adults who want weekly talk therapy with messaging between sessions
- Cost: $70–$100 per week, billed weekly or every four weeks; cancel anytime.
- Insurance: In network with 125+ plans, including select Aetna, Cigna, UnitedHealthcare/Optum and Blue Cross Blue Shield (Anthem, CareFirst, Highmark) plans, where available.
- Medication: Not offered
- Ages: Adults 18+ (teens through TeenCounseling)
Our expert review
BetterHelp is the largest online talk-therapy network we reviewed, with more than 30,000 licensed therapists and four ways to connect, messaging, live chat, phone and video. It suits adults who want a steady weekly routine and the freedom to switch therapists easily.
Talk therapy only, cannot diagnose or prescribe.
Pros
- The largest network we reviewed, more than 30,000 licensed therapists.
- Four ways to talk (messaging, live chat, phone, video), which you can mix week to week.
- Unlimited messaging with your therapist between live sessions.
Considerations
- Therapists cannot make an official diagnosis or prescribe medication.
- Not suitable for crisis situations, court-ordered therapy, minors or anyone under a guardian’s care.
Best for upfront cash prices
- Best for: Booking a therapist of your choice at an upfront cash price, session by session
- Cost: Each provider sets an upfront cash price you see before booking.
- Insurance: Does not bill insurance.
- Medication: Prescribing available
- Ages: Adults for mental health care (Sesame also lists separate pediatric visits)
Our expert review
Sesame is a marketplace where you see each clinician's cash price before you book and choose your own therapist. Visits start around $34, which makes it a strong option if you don't have insurance or want to avoid subscriptions.
No insurance billing; HSA/FSA accepted. Prices set by each provider.
Pros
- Upfront prices shown before you book, no insurance paperwork, copays or surprise bills.
- You choose your own clinician from provider profiles, reviews and open time slots.
- Same-day visits are often available.
Considerations
- Providers on Sesame do not prescribe controlled substances, including ADHD stimulants, benzodiazepines and controlled sleep medications such as zolpidem.
- Prices vary by provider and state, so the cost of your visit depends on who you book.
Best for insurance coverage
- Best for: Adults, teens and couples who want to use insurance, including Medicare or TRICARE
- Cost: Self-pay therapy $69/week (messaging), $99/week (video + messaging) or $109/week (adds workshops).
- Insurance: In network with plans covering 100+ million Americans, including select Aetna, Cigna, Optum, Anthem, Premera, Medicare and TRICARE plans.
- Medication: Prescribing available
- Ages: Adults 18+; teens 13–17 with parental consent (therapy only)
Our expert review
Talkspace has the broadest insurance network of the services we reviewed, with an average therapy copay of $10 and many members paying $0. It also offers psychiatry under the same roof, which makes it a practical choice if you may want medication support later.
Self-pay therapy $69–$109 per week; psychiatry prescribes non-controlled medication only.
Pros
- The broadest insurance coverage we’ve reviewed, including Medicare and TRICARE, with an average $10 therapy copay.
- Therapy and psychiatry under one roof, so a therapist and prescriber can work from the same account.
- Covers adults, teens (13–17) and couples directly, not through separate sister sites.
Considerations
- Live video sessions on self-pay plans are 30 minutes, up to four a month, shorter than a typical 45–60 minute session.
- Messages are answered within a day or two, five days a week, not in real time.
Best for therapy plus a doctor
- Best for: Insured adults who want therapy and a prescribing doctor in one place
- Cost: Therapy $169 per session.
- Insurance: Accepts many insurance plans.
- Medication: Prescribing available
- Ages: Adults 18+ for therapy
Our expert review
PlushCare combines per-session video therapy with online doctor visits that can prescribe non-controlled medication. It is a good fit if you want one service for both, though $169 per therapy session is high if you pay out of pocket every week.
Individual adult therapy at $169 per session; insurance accepted.
Pros
- Therapy and medical care, including medication, from one service.
- Accepts many insurance plans, which can lower the cost substantially.
- Per-session pricing with no weekly subscription for therapy.
Considerations
- $169 per therapy session is high if you pay out of pocket every week.
- Therapy is for individual adults only, no couples, family or under-18 therapy.
Order reflects editorial judgment against our criteria, not a numeric score. Prices and coverage change; confirm current details with each service.
Our top picks at a glance
We compared online therapy platforms on clinician credentials, evidence-based care, pricing transparency, insurance, privacy and crisis policy. Our four top picks are below; each has an in-depth review. Rankings reflect editorial judgment against our published criteria, and commercial relationships never decide inclusion or order.
What to know before you choose
Online therapy has moved from a niche to a mainstream way to receive mental health care. It can mean weekly video sessions with a licensed therapist, phone calls or secure messaging, and it is offered by subscription platforms, insurance-friendly telehealth practices and marketplaces where you pick an independent therapist. With so many choices, the question isn’t just “which is best?” but “which is best for me?” This guide explains how services differ, what to look for, who online therapy suits and how our reviews can help you compare. We don’t rank services by a single score, and we explain how we evaluate them in our editorial process.
This page contains affiliate links, explained in our affiliate disclosure.
How online therapy services differ
Online therapy services fall into a few broad models:
- Subscription platforms that match you with a therapist and bundle messaging and live sessions.
- Per-session telehealth practices, often in-network with insurers.
- Directories that help you find independent therapists offering video sessions.
The right choice depends on your budget, whether you want to use insurance, the type of support you need, and how much you value choosing your own therapist.
You can see these differences in the services we review. BetterHelp matches you with a therapist and includes messaging between sessions for a weekly fee, PlushCare bills per session and accepts insurance, and Sesame lets you choose a therapist yourself from a marketplace at upfront cash prices.
| Service | Best for | Notes |
|---|---|---|
| BetterHelp | Adults who want weekly talk therapy with messaging between sessions | Talk therapy only, cannot diagnose or prescribe |
| Talkspace | Adults, teens and couples who want to use insurance, including Medicare or TRICARE | Self-pay therapy $69–$109 per week; psychiatry prescribes non-controlled medication only |
| PlushCare | Insured adults who want therapy and a prescribing doctor in one place | Individual adult therapy at $169 per session; insurance accepted |
| Sesame | Booking a therapist of your choice at an upfront cash price, session by session | No insurance billing; HSA/FSA accepted; prices set by each provider |
Read in-depth reviews of BetterHelp, Talkspace, PlushCare and Sesame, or see head-to-head comparisons.
What to look for
- Licensed clinicians who can practice where you live.
- Clear pricing, including what happens after any introductory offer.
- Easy cancellation and the ability to pause.
- Therapist choice and the option to switch.
- Privacy, read how your data is used, and whether it is shared with advertisers.
- Formats, live video is the most studied; messaging-only has less evidence.
- Evidence-based approaches, such as CBT, and a way to track progress.
- A crisis policy that explains what happens if you’re at risk.
Does online therapy work?
Research on video-based therapy for common problems such as depression, anxiety and stress is generally encouraging, with outcomes comparable to in-person therapy for many people. The therapeutic relationship matters at least as much as the setting, so the ability to find a good match, and to switch if it isn’t working, is more important than the platform’s marketing. Evidence for messaging-only therapy is thinner, and it may suit some people as a complement rather than a replacement for live sessions. See online therapy for a fuller discussion.
Who online therapy may suit
People with mild to moderate symptoms of common conditions such as anxiety, depression or stress, who have a private space and a stable internet connection. It can also suit people with busy schedules, limited local options, mobility or transport difficulties, or who find it easier to open up from home.
Who may need a different level of care
People in crisis, with severe symptoms, active substance withdrawal, or conditions requiring close monitoring may need in-person or more intensive care. Online platforms generally can’t provide court-ordered therapy or emergency care. If you are in immediate danger, see Get Help Now.
Cost and insurance
Self-pay prices among services we review range from roughly $34 for some marketplace visits to $169 for a single session, or $70–$100 a week on subscription. Several services also work with insurance, with copays often much lower than self-pay prices. If insurance matters to you, check whether a service is in network with your specific plan before you sign up. See online therapy without insurance and affordable therapy for strategies.
Privacy
Online therapy involves sharing sensitive information through apps and websites. Before signing up, read the privacy policy, check what the service does with data for advertising and analytics, and use a secure connection and private space for sessions. Our provider reviews summarize privacy practices and any regulatory actions that we’re aware of.
Getting started
- Decide what you want help with and how much you can spend.
- Shortlist two or three services and read their reviews.
- Check the clinician’s license and the cancellation terms.
- Try a few sessions and judge fit; switch if it isn’t right.
- Add in-person or specialist care if your needs go beyond what online therapy offers.
For more on choosing a therapist, read how to find the right therapist and our find care overview.
Bottom line
The best online therapy service is the one that fits your budget, needs and preferences and gives you a licensed, well-matched therapist you can work with. Use this guide and our reviews to shortlist, then trust your own experience over the first few sessions.
Side-by-side comparison
| Service | May suit | Pricing | Insurance | Medication | Links |
|---|---|---|---|---|---|
| BetterHelp | Adults who want weekly talk therapy with messaging between sessions | $70–$100 per week, billed weekly or every four weeks; cancel anytime. Price varies with location, referral source, preferences and therapist availability. | In network with 125+ plans, including select Aetna, Cigna, UnitedHealthcare/Optum and Blue Cross Blue Shield (Anthem, CareFirst, Highmark) plans, where available. Average copay $23 per session for eligible members. Not Medicare, Medicaid or TRICARE. HSA/FSA accepted. | Not offered | Read review |
| Sesame | Booking a therapist of your choice at an upfront cash price, session by session | Each provider sets an upfront cash price you see before booking. Mental health visits from about $34; psychiatrist appointments average about $132 for 45 minutes. Mental Health Rx subscription $79/month. | Does not bill insurance. HSA and FSA accepted. Your pharmacy may still run insurance for the medication itself. | Available | Read review |
| Talkspace | Adults, teens and couples who want to use insurance, including Medicare or TRICARE | Self-pay therapy $69/week (messaging), $99/week (video + messaging) or $109/week (adds workshops). Couples $109/week. Psychiatry $299 initial evaluation, $175 per follow-up. | In network with plans covering 100+ million Americans, including select Aetna, Cigna, Optum, Anthem, Premera, Medicare and TRICARE plans. Average copay $10 for therapy and $15 for psychiatry; many members pay $0. EAP, HSA and FSA accepted. | Available | Read review |
| PlushCare | Insured adults who want therapy and a prescribing doctor in one place | Therapy $169 per session. Doctor visits $129 without insurance, plus a membership of $19.99/month or $149/year. | Accepts many insurance plans. PlushCare says most patients with in-network insurance pay $30 or less per doctor visit. FSA/HSA receipts provided for therapy. | Available | Read review |
- May suit
- Adults who want weekly talk therapy with messaging between sessions
- Pricing
- $70–$100 per week, billed weekly or every four weeks; cancel anytime. Price varies with location, referral source, preferences and therapist availability.
- Insurance
- In network with 125+ plans, including select Aetna, Cigna, UnitedHealthcare/Optum and Blue Cross Blue Shield (Anthem, CareFirst, Highmark) plans, where available. Average copay $23 per session for eligible members. Not Medicare, Medicaid or TRICARE. HSA/FSA accepted.
- Medication
- Not offered
- May suit
- Booking a therapist of your choice at an upfront cash price, session by session
- Pricing
- Each provider sets an upfront cash price you see before booking. Mental health visits from about $34; psychiatrist appointments average about $132 for 45 minutes. Mental Health Rx subscription $79/month.
- Insurance
- Does not bill insurance. HSA and FSA accepted. Your pharmacy may still run insurance for the medication itself.
- Medication
- Available
- May suit
- Adults, teens and couples who want to use insurance, including Medicare or TRICARE
- Pricing
- Self-pay therapy $69/week (messaging), $99/week (video + messaging) or $109/week (adds workshops). Couples $109/week. Psychiatry $299 initial evaluation, $175 per follow-up.
- Insurance
- In network with plans covering 100+ million Americans, including select Aetna, Cigna, Optum, Anthem, Premera, Medicare and TRICARE plans. Average copay $10 for therapy and $15 for psychiatry; many members pay $0. EAP, HSA and FSA accepted.
- Medication
- Available
- May suit
- Insured adults who want therapy and a prescribing doctor in one place
- Pricing
- Therapy $169 per session. Doctor visits $129 without insurance, plus a membership of $19.99/month or $149/year.
- Insurance
- Accepts many insurance plans. PlushCare says most patients with in-network insurance pay $30 or less per doctor visit. FSA/HSA receipts provided for therapy.
- Medication
- Available
Prices and coverage change often. Always confirm current details with the provider.
How we evaluate services
Every service in our comparisons is assessed against the same criteria. Commercial relationships never change our criteria, our findings or the order in which services appear. Full methodology.
Clinician credentials
Are clinicians licensed, and can you verify their credentials and the jurisdictions they practice in?
Evidence-based care
Does the service offer approaches with research support, and does it measure progress?
Pricing transparency
Are total costs, billing frequency and cancellation terms clear before you sign up?
Insurance and affordability
Does it accept insurance, provide superbills, or offer lower-cost options?
Privacy and data practices
How is health information stored and shared? Is any data used for advertising?
Safety and crisis policy
Does the service screen for risk, explain what happens in a crisis and refer to higher levels of care when needed?
Access and fit
How quickly can you start, can you choose or switch clinicians, and are formats (video, phone, messaging) suitable?
When to seek professional help
Consider talking with a doctor or licensed mental health professional if symptomslast for more than two weeks, keep coming back, or make it harder to manage work, school, relationships or daily tasks. You don’t need to wait until things feel severe, getting support early often makes things easier.
If you’re thinking about harming yourself or are in immediate danger, call your local emergency number. In the US, call or text 988 (Suicide & Crisis Lifeline).Crisis resources in other countries.
Explore care optionsFrequently asked questions
How much does online therapy cost?
Is online therapy covered by insurance?
How do you choose which services to include?
References
We rely on government health agencies, professional medical organizations, peer-reviewed research and academic institutions. Read our sourcing standards.
About this article
Written by
ExploreMentalHealth Editorial Team
Our editors research and write every article using government health agencies, professional medical organizations and peer-reviewed research, following our published editorial standards.
- First published
- September 19, 2026
- Last updated
- October 21, 2026
- Last medically reviewed
- Review pending