Online mental health care has moved from a niche to a mainstream way to get support. 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 cash-pay marketplaces. With so many choices, the question is not just which service is best, but which is best for you.
In this guide we walk through what separates the services we reviewed, what they cost and how to choose between therapy, psychiatry and specialist care. Every service has its own in-depth review, and the table above links to each one.
#1 Ranked Service: Best Overall
Talk therapy means regular sessions with a licensed therapist to work on stress, anxiety, low mood, relationships and more. BetterHelp is a therapy-only service: its therapists cannot diagnose conditions or prescribe medication.
Psychiatry and medication care means an evaluation by a prescribing clinician who can start and adjust medication. Talkspace, Rula, PlushCare, Sesame and Lemonaid Health can prescribe non-controlled medication, and Lemonaid Health offers medication care without talk therapy. A prescription is never guaranteed.
Specialist care is for people whose symptoms have not improved with standard treatment. Better U prescribes off-label oral ketamine for home use with clinician oversight, and it is not a first step for most people.
Not every service suits every person. When comparing your options, look at:
Across the 8 services we compared, self-pay pricing falls into three broad groups:
From about $34
Sesame lists upfront cash prices per visit, with no insurance needed.
$69–$109 a week · $95 a month
Subscription therapy at Talkspace and BetterHelp, or monthly medication care at Lemonaid Health.
$76–$169 a session
PlushCare therapy and Better U ketamine sessions, which are priced per session or in packages.
After reviewing every service against our criteria, BetterHelp is our top pick for weekly talk therapy: the largest network we reviewed, four ways to connect and an average $23 copay for eligible insured members. If you want to use insurance, including Medicare or TRICARE, Talkspace is worth a close look. If you want therapy and a prescribing doctor in one place, consider PlushCare, and if you would rather pay a clear cash price, Sesame shows it before you book.
Our #1 Pick: Start Today
Read the full reviews and find the right fit for your needs.
View All ReviewsIt depends on what you need. We rank BetterHelp first for weekly talk therapy, then Talkspace for insurance coverage (including Medicare and TRICARE), Sesame for upfront cash prices, Rula for low insured copays and Talkiatry for in-network psychiatry, followed by PlushCare for therapy plus a prescribing doctor. Each has a full review that explains who it suits.
Self-pay prices in this comparison range from about $34 for a Sesame mental health visit to $169 for a PlushCare therapy session. Subscription therapy runs $69–$109 a week at Talkspace and $70–$100 a week at BetterHelp, and Rula charges $150 a session without insurance. Insurance can lower these costs, so check your plan before you enroll.
Therapy-only services such as BetterHelp cannot prescribe. Talkspace, Rula, Talkiatry, PlushCare, Sesame and Lemonaid Health can prescribe after an evaluation, and Talkspace, PlushCare, Sesame and Lemonaid Health do not prescribe controlled substances. None of the services here prescribe controlled substances for routine care, and a prescription is never guaranteed.
Sometimes. Talkspace, Rula, Talkiatry and BetterHelp are in network with many plans, and PlushCare accepts insurance. Sesame and Lemonaid Health are cash-pay. Coverage depends on your plan, state and clinician, so confirm with your insurer first.
For many common concerns such as anxiety and depression, research supports online therapy as a reasonable option, and the strongest predictor of success is usually your fit with your clinician. It is not suited to emergencies or severe symptoms, which need in-person or crisis care.
Online services in this comparison are not for emergencies. In the US, call or text 988 (Suicide & Crisis Lifeline), or call 911. See our Get Help Now page for more resources.
We check that clinicians are licensed and that their credentials can be verified.
Clear prices, billing frequency and cancellation terms. We look at total cost, not just the headline rate.
What each service does and does not provide, from talk therapy to prescribing, and how it handles crisis.
How your data is handled, how quickly you can start and whether insurance is accepted.
The information on ExploreMentalHealth is provided for educational and comparison purposes only. It is not medical advice and does not replace consultation with a qualified healthcare professional. Some links on this page may earn us a commission, which never affects our conclusions. If you are in crisis, call or text 988 in the US, or visitGet Help Now.