Online Therapy That Takes Insurance: What It Really Costs

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Online therapy that takes insurance is easy to find now. Talkspace, Grow Therapy, Headway, Alma, Rula, SonderMind, Brightside, Thriveworks and Cerebral all bill major health plans for licensed therapists by video, and if your therapist is in network you usually pay only your copay or coinsurance after any deductible. BetterHelp, long a cash-pay service, now takes some commercial plans, with coverage that varies by state and plan.

If you are in crisis or thinking about suicide, call or text 988 (the Suicide and Crisis Lifeline in the US) now.

It’s late, and you’re holding your insurance card. You already know you want to talk to someone. What you don’t know is whether it’s going to cost you fifteen dollars or two hundred.

I’m Figs O’Sullivan, a licensed marriage and family therapist. I have been a couples therapist in San Francisco for seventeen years, and I built Figlet, a coaching tool that insurance does not cover, because it is coaching and not therapy. So keep my bias in mind. I checked the networks and prices below in October 2026. They change constantly, so confirm everything with your plan and the platform before you book.

Which online therapy platforms take insurance?

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• Talkspace: in network with Aetna, Anthem, Blue Cross Blue Shield, Cigna, Optum, Carelon, Regence and TRICARE, plus Medicare in certain states. It offers psychiatry too.
• Grow Therapy: you pay per session, with no subscription. It says it works with 125+ plans, and takes Medicare and Medicaid in some states.
• Headway: you pay your plan’s in-network cost share per session. Its help center says it takes select Medicare Advantage plans and some Medicaid managed care plans in some states, but not Original Medicare, and it doesn’t work with out-of-network benefits.
• Alma: a big network of independent therapists, online or in person, working with most commercial plans. Generally not Medicare or Medicaid.
• Rula: says it works with 170+ plans, including Medicare, and managed Medicaid in select states.
• SonderMind: says its therapists are in network with most major plans, including Medicare and Medicare Advantage, but not Medicaid or TRICARE.
• Brightside: therapy and psychiatry together, built for depression and anxiety. It takes many commercial plans, and Medicare in select states.
• Thriveworks: therapy and psychiatry, online or in person. It takes Medicare and lists Medicare copays of about $0 to $55 a session. It does not take Medicaid.
• Cerebral: a narrower list, mainly Aetna, Cigna, Anthem and some Blue Cross plans.
• BetterHelp: cash-pay for years. It now bills some commercial plans, including Aetna, Cigna, UnitedHealthcare and some Blue Cross Blue Shield plans, but which states and plans qualify keeps changing, so run its insurance check before you sign up. It does not take Medicare, Medicaid or TRICARE.

Insurance gets you in the door. It doesn’t decide whether therapy works. When a clinician signs a contract with an insurer, the insurer decides what an hour of that clinician’s time is worth. Seventeen years of training or six months out of grad school, the rate is identical. Most in-network providers are generalists, so match the clinician to the work, not to the modality. If after a handful of sessions you still feel like a stranger in the room, ask for someone else.

How much does online therapy cost with insurance?

In network, usually somewhere between nothing and a normal specialist copay per session, once your deductible is met. Before the deductible is met, you pay the full amount your insurer has agreed to for that session, which can be a real shock if nobody warned you.

Three numbers decide what you pay:

• Copay: a flat amount per session, the same every week.
• Coinsurance: a percentage of the insurer’s allowed fee, for example 20%. Your cost moves when the fee moves.
• Deductible: what you pay in full each year before the plan starts sharing the cost. High-deductible plans can mean paying the whole allowed amount for months.

The platforms publish their own averages, so read them as marketing numbers, not promises. Rula says its patients typically pay $15 a session. BetterHelp reports an average copay of about $23 for members whose plan it takes. Thriveworks lists Medicare copays of roughly $0 to $55. Your plan, not the platform, decides your real number.

Without insurance, Talkspace’s self-pay plans run about $69 to $109 a week and BetterHelp’s about $65 to $100 a week, depending on where you live and the plan. Thriveworks and Headway both cite a 2024 analysis putting the average private practice session at around $143 without insurance. If you’re weighing the two subscription platforms side by side, I compared them in BetterHelp vs Talkspace.

The person on the phone may give you something that sounds like coverage but behaves like a refusal. “Mental health is covered” is not the same as “this therapist, by video, is covered at a $20 copay.” Ask for the second sentence.

Is online therapy covered the same as in-person therapy?

Usually, yes. Federal mental health parity rules push most plans to cover mental health care on terms comparable to medical care, and many states require insurers to cover telehealth on the same terms as an office visit. In practice, online sessions are generally covered the same way as in-person sessions, as long as the clinician is in network.

Two catches. Your therapist generally needs to be licensed in the state where you live, so a therapist in another state may not be able to see you even if the platform shows them. And “in network” means in network with your specific plan, not just your carrier. A therapist can take Aetna and still not take your employer’s Aetna plan.

How do I check if my insurance covers online therapy?

Call the member services number on the back of your card and ask for behavioral health. The person on the phone may give you an answer that sounds like a yes but works like a no, so ask these questions one at a time and write the answers down:

• Is outpatient therapy by video covered the same way as in-person therapy?
• What’s my in-network cost: a flat copay, or coinsurance (a percentage of the fee)?
• What’s my deductible, and how much of it have I already met?
• Do I need prior authorization or a referral, and is there a limit on sessions?
• Do I have out-of-network behavioral health benefits, and what percentage do you reimburse?
• Is this particular therapist or platform in network for my plan, not just for the company?
• Does coverage require a diagnosis, and will it be shared with anyone besides you?

Ask for a call reference number before you hang up. Then put your insurance details into the platform’s own coverage checker. Get the answer in writing before you assume anything.

What does insurance need from me?

A diagnosis. Insurance was built to pay for treating one sick person. To get paid, the therapist has to show the care is medically necessary and enter a diagnosis code, such as depression, anxiety or PTSD. Problems of living, like relational distress, are coded as Z-codes, and insurers almost never pay for Z-codes.

If anxiety is what you need treated, I compared the best online therapy for anxiety, including which options take insurance.

That comes with a tradeoff. The diagnosis stays in your medical record. It follows you, and it can come up later, for example on future insurance applications. Ask any therapist plainly how they bill before you commit, and weigh the privacy cost honestly.

A diagnosis can also change the story you tell about yourself. A couple sat with me who had both been diagnosed, him with OCD and her with ADHD. He’d grown up in a home where a spotless house meant he was loved and safe, so when the house isn’t clean his system panics. When connection gets intense she feels overwhelmed and has to step away to stay regulated. If we had worked only from those labels, the relationship would have died by certainty. Underneath them were two ordinary attachment wounds. To him, her stepping away read as her not being there for him. To her, his fixation read as one more way she was disappointing him. No diagnosis code captures that.

Is online therapy through insurance private?

What you say in session stays protected. Your therapist can’t share session content with insurers or employers without your written consent. But if you use insurance, a diagnosis code is submitted for billing, and that diagnosis becomes part of your medical record. Some people pay out of pocket specifically to keep the work fully outside the insurance system. If privacy from your insurer matters to you, ask about self-pay rates before the first session, not after.

What if my therapist is out of network?

You pay the full fee yourself. The therapist gives you a superbill, an itemized receipt with the diagnosis and procedure codes, and you send it to your insurer. If you have out-of-network benefits, they pay back a percentage once you’ve met your deductible. The fine print isn’t generous. Deductibles are high, “usual and customary” caps often come in below what you actually paid, and the checks take weeks. Some people get back forty percent. Some get back nothing. You can usually pay with pre-tax money from an HSA or FSA, which isn’t reimbursement but is a real discount.

Can I use my EAP, HSA or FSA for online therapy?

Often, yes, and these are the benefits people most often leave sitting unused.

EAP. If you have a job with benefits, look for your Employee Assistance Program. EAP counseling is free and confidential, and the number of sessions depends on your employer: in the plans I checked it ranged from three to ten sessions per issue. Some employers also cover Talkspace outright through an employer code or the EAP. Your benefits portal or HR will know. Use EAP for a first read and for triage. Don’t expect deep work in a handful of sessions, and don’t pass up a free resource either.

HSA and FSA. Pre-tax money in a health savings account or flexible spending account is generally usable for therapy, including online sessions with a licensed clinician. It’s not reimbursement, it’s a tax discount, but the savings are real. Keep your receipts or superbills.

Do Medicare and Medicaid cover online therapy?

Medicare Part B covers mental health care by telehealth, including from home. After your Part B deductible, you generally pay 20% of the Medicare-approved amount, unless you have a supplemental plan that picks some of that up. Since January 2024, licensed marriage and family therapists and mental health counselors can bill Medicare too. Federal law will eventually require an in-person visit for some home telehealth mental health care, but Congress has delayed that requirement, and a CMS FAQ updated in February 2026 puts the start at January 1, 2028.

Among the online platforms, Talkspace (in certain states), Rula, SonderMind, Thriveworks and Brightside (in select states) take Medicare, and Grow takes it in some states. Headway takes only select Medicare Advantage plans, not Original Medicare. If you have Medicare Advantage, your plan has its own network, so check that the therapist is in network with your Advantage plan specifically.

Medicaid is run by each state, which sets its own telehealth rules, so call the number on your Medicaid card. Grow Therapy, Rula and Headway take some Medicaid or managed Medicaid plans in a limited set of states. Thriveworks, SonderMind and BetterHelp don’t take Medicaid.

Does insurance cover couples therapy online?

Rarely. Your marriage isn’t a billable patient. Some therapists bill one partner’s individual diagnosis as family therapy with the patient present, which puts a diagnosis on that partner’s record. Some platforms list couples therapy, but check whether it’s covered or self-pay before you start. I wrote the full breakdown in does insurance cover couples therapy, and if you’re budgeting for it without insurance, here is what couples therapy really costs.

Watch out for one trap. Because the relationship rarely gets covered, people take it to the individual therapist their plan does cover. That therapist only ever hears one side, and the work can end up pulling against the marriage. You can’t rebuild a marriage in a room that only hears one side of the dance. If you and your partner live in California and want a licensed couples therapist, that’s what we do at Empathi online couples therapy, with superbills for out-of-network reimbursement. If the pain is your relationship and you want to start on your own tonight, even if your partner won’t come, you can start Figlet relationship coaching.

How do I choose an online therapist who takes insurance?

Filter by your plan first, then choose the person. The platform is a delivery system. What you’re buying is a person, and the best therapy is the one you’ll keep showing up to, with someone you trust.

I learned that the humbling way. When I started as a couples therapist I thought I was exceptional. Then I noticed about 40% of my couples weren’t coming back after the first session. I asked a friend how many of his came back for a second. He looked at me, confused. Everyone comes back for a second session. That humbled me enough to learn. Fit isn’t a soft extra. It’s the thing that decides whether the money you spend does anything at all.

So on the first call, ask one sharp question: “What is your specific training for what I’m dealing with, and what approach do you use?” If you hear a vague “I use an eclectic approach,” keep looking. Depth in one model beats a sampler platter of five. Then notice your body at the end of the first session. You should leave feeling a little more met than when you walked in. If you’d find it easier to start with a man, or a woman, ask for one. You’re allowed to be picky about who gets to see you.

And if medication may be part of it, pick a platform that pairs therapy with psychiatry, like Brightside or Talkspace, and confirm that both are covered under your plan, because therapy and psychiatry are sometimes billed differently.

What if I have no coverage at all?

Open Path Collective connects people who are uninsured or underinsured with licensed therapists at reduced rates after a one-time membership fee. Its rates have changed recently, so check the current numbers on its site. University training clinics offer sliding-scale therapy with supervised early-career clinicians, sometimes for as little as forty dollars. Quality varies. Your employer’s EAP may cover several free sessions. I mapped every genuinely free option, from 988 to community health centers, in free online therapy: what is actually free, and for couples on a budget, sliding scale couples therapy.

Coaching is a different thing. It takes you from where you are now to where you want to go, and it only addresses the past when the past shows up in the present. For a lot of stuck, lonely, burnt-out weeks, that’s the right size. It isn’t the right size for depression, OCD, ADHD, addiction, trauma, eating disorders or bipolar disorder. Those belong with a licensed therapist or a psychiatrist. Figlet isn’t covered by insurance, it isn’t treatment, and no AI is a therapist, including mine. If home isn’t safe, because someone is hitting you, threatening you, blocking the door, controlling your money or your phone, or following you, that isn’t a coaching problem. Get help today. The National Domestic Violence Hotline is 1-800-799-7233.

Why is it so hard to make the call?

Usually it isn’t the money. When you tell yourself “my problems aren’t bad enough,” that’s exactly how shame hides. “We can’t afford therapy, so we’ll just figure it out” is often a softer way of saying “I’m too scared to walk into a room and be seen.” That fear deserves to be said out loud. Saying it is already half the work.

What to do tonight

Many insurers run behavioral health lines around the clock. Five small steps, none longer than ten minutes:

1. Find your insurance card and a pen. Write today’s date at the top of a page.
2. If your insurer’s behavioral health line is open, call tonight and say this, word for word: “I want to see a licensed therapist by video. Is that covered in network, what will I pay per session after my deductible, and do I need prior authorization?” Write down the answer and the reference number.
3. If the line is closed, log into your member portal and look up two numbers: your deductible remaining and your behavioral health copay or coinsurance.
4. Put your plan into the coverage checker on two of the platforms above, and screenshot what each one quotes you.
5. Write one sentence you’d say to a therapist in the first five minutes: “What keeps happening is…” You’ll walk into the first session already knowing where to start.

If you’re the partner who thinks they don’t need this

If someone you love is pushing for therapy and you’re pushing back on the cost, notice whether it’s really about money. Resistance to the cost is often resistance to what it implies: that something needs help, that you might be found at fault. Nine times out of ten it’s the fear of being found bad. “I’m scared of what we’ll find” will get you further than another argument about the budget.

Where to go from here

If you’re comparing platforms beyond insurance, read my honest guide to the best online therapy. If you’re still deciding between kinds of help, read life coach vs therapist.

If what you need tonight is help moving forward rather than treatment, I built Figlet for exactly that. It’s a coaching tool, not therapy. You tell it what happened, it shows you the pattern you’re caught in, and it gives you one line to say. Start Figlet Life Coaching free tonight.

Frequently asked questions

What is the best online therapy that takes insurance?

The one that’s in network with your plan and gets you a therapist you trust. Talkspace and Grow Therapy cover many major plans, Headway and Alma let you choose an independent therapist, and Brightside fits if depression or anxiety may need medication.

Which is cheaper, Talkspace or BetterHelp?

If you’re paying cash, BetterHelp is usually a little cheaper, at about $65 to $100 a week against Talkspace’s roughly $69 to $109. With insurance, Talkspace usually comes out cheaper, because it has been in network with far more plans for longer and many members pay a small copay.

Is $200 a session a lot for therapy?

Nationally, yes, it’s on the high side. One large 2024 analysis, cited by Thriveworks and Headway, put the average private practice session at around $143. In cities like San Francisco or New York, $200 to $350 is common for experienced specialists, and good couples work often costs more. With insurance and a superbill, your actual cost can be much lower.

What is the 2 year rule in therapy?

It’s an ethics rule. The American Psychological Association’s Ethics Code (Standard 10.08) bars psychologists from sexual relationships with former clients for at least two years after therapy ends. Even after that, it’s allowed only in the most unusual circumstances, and the psychologist has to show there was no exploitation.

Does insurance cover online therapy?

Often, yes. Most plans cover video sessions with an in-network licensed therapist the same way they cover office visits, as long as there’s a diagnosis.

How much does online therapy cost with insurance?

Usually your copay or coinsurance per session once your deductible is met, which for many people is somewhere between nothing and a typical specialist copay. Before the deductible is met, you pay the insurer’s full allowed amount. Platforms report their own averages (Rula says about $15, BetterHelp about $23), but your plan decides the real number.

Does BetterHelp take insurance?

Sometimes, now. BetterHelp was cash-pay for years and has started billing some commercial plans, including Aetna, Cigna, UnitedHealthcare and some Blue Cross Blue Shield plans. Which states and plans qualify keeps changing, so run its insurance check. It doesn’t take Medicare, Medicaid or TRICARE.

Is Headway better than BetterHelp if I want to use my insurance?

If your plan is on Headway’s list, it’s usually the more direct route: you pay your in-network cost share per session, with no weekly subscription, and you choose an independent therapist. BetterHelp’s insurance network is newer and narrower. Check both with your plan details, and pick the one where you find a therapist you trust.

Does Medicare cover online therapy?

Yes. Medicare Part B covers mental health care by telehealth, including from home, and you generally pay 20% of the approved amount after your deductible. Talkspace (in certain states), Rula, SonderMind and Thriveworks take Medicare. Headway takes only select Medicare Advantage plans.

Can I use my HSA or FSA for online therapy?

Generally, yes, for therapy with a licensed clinician. It isn’t reimbursement, but paying with pre-tax money is a real discount. Check with your plan administrator before you spend it, and keep your receipts.

Does insurance cover couples therapy online?

Rarely, because relationship distress isn’t a billable diagnosis. Some therapists bill under one partner’s diagnosis, and that puts the diagnosis on that partner’s record.

How do I check if my insurance covers therapy?

Call the number on your card, ask for behavioral health, and ask about telehealth coverage, your deductible, copay or coinsurance, prior authorization and out-of-network benefits. Keep the call reference number.

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Figs O'Sullivan

Founder · EFT couples therapist

“What I would tell you at 10pm, if I could.”