Provider vs. provider
BetterHelp vs. Sesame (2026): Subscription Therapy or Pay-Per-Visit Care?
BetterHelp vs. Sesame compared — weekly subscription vs. pay-per-visit prices, insurance, choosing your own clinician, psychiatry and prescriptions, and who each suits best.
Our bottom line
Choose BetterHelp for ongoing weekly talk therapy with messaging in between; choose Sesame if you want to pay per visit, pick your own clinician, or need a prescription for a non-controlled medication.
BetterHelp vs. Sesame: side by side
| BetterHelp | Sesame | |
|---|---|---|
| Type of service | Online therapy | Online therapy, psychiatry and prescriptions |
| Pricing | $70–$100 per week, billed weekly or every four weeks; cancel anytime. Price varies with location, referral source, preferences and therapist availability. | 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 | 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. | Does not bill insurance. HSA and FSA accepted. Your pharmacy may still run insurance for the medication itself. |
| Prescribes medication | No | Yes (non-controlled medications, where clinically appropriate) |
| Ages served | Adults 18+ (teens through TeenCounseling) | Adults for mental health care (Sesame also lists separate pediatric visits) |
| Services | Individual therapy (adults); Couples therapy (through Regain); Teen therapy (through TeenCounseling, ages 13–19); Messaging, live chat, phone and video sessions; 150+ digital worksheets and 20+ free weekly group seminars | Online therapy sessions with a licensed therapist; Online couples therapy sessions; Online psychiatry consults with psychiatrists and psychiatric nurse practitioners; Mental health consults and prescription refill visits with primary care providers; Mental Health Rx subscription for ongoing medication care; In-person mental health consults in some areas |
| Availability | 100% online across the US on phone or computer; therapists work only with clients in the states where they are licensed. | Online across the US, with providers listed by state. Sesame says psychiatrists are not available in every state. |
| Links | Visit BetterHelp (opens in a new tab)Read our BetterHelp review | Visit Sesame (opens in a new tab)Read our Sesame review |
- Type of service
- Online therapy
- 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.
- Prescribes medication
- No
- Ages served
- Adults 18+ (teens through TeenCounseling)
- Services
- Individual therapy (adults); Couples therapy (through Regain); Teen therapy (through TeenCounseling, ages 13–19); Messaging, live chat, phone and video sessions; 150+ digital worksheets and 20+ free weekly group seminars
- Availability
- 100% online across the US on phone or computer; therapists work only with clients in the states where they are licensed.
- Type of service
- Online therapy, psychiatry and prescriptions
- 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.
- Prescribes medication
- Yes (non-controlled medications, where clinically appropriate)
- Ages served
- Adults for mental health care (Sesame also lists separate pediatric visits)
- Services
- Online therapy sessions with a licensed therapist; Online couples therapy sessions; Online psychiatry consults with psychiatrists and psychiatric nurse practitioners; Mental health consults and prescription refill visits with primary care providers; Mental Health Rx subscription for ongoing medication care; In-person mental health consults in some areas
- Availability
- Online across the US, with providers listed by state. Sesame says psychiatrists are not available in every state.
Details last verified September 25, 2026. Prices and coverage change often — confirm current details with each provider. Links marked as affiliate links may earn us a commission at no extra cost to you.Learn more
BetterHelp and Sesame both get you to a licensed mental health professional online, but they are built on opposite models. BetterHelp is a subscription: you pay weekly and get an assigned therapist, unlimited messaging and live sessions. Sesame is a marketplace: you browse clinicians, see each one’s price upfront and pay per visit — and some of those clinicians can prescribe.
The short answer
- BetterHelp suits people who want ongoing weekly talk therapy and like messaging a therapist between sessions.
- Sesame suits people who want to pay as they go, pick their own clinician, or need a prescription.
Cost and insurance
| BetterHelp | Sesame | |
|---|---|---|
| How you pay | Weekly subscription | Per visit, or $79/month Mental Health Rx |
| Typical price | $70–$100 per week | Visits from about $34; psychiatrist visits average about $132 for 45 minutes |
| Insurance | 125+ plans where available; avg. $23 copay | Doesn’t bill insurance |
| HSA/FSA | Yes | Yes |
With Sesame you see the exact price before you book, and there is no ongoing charge unless you choose the subscription. BetterHelp shows your weekly price after the intake questionnaire, and it keeps billing until you cancel. If you have an in-network plan, BetterHelp’s insurance option may bring weekly therapy down to a small copay — something Sesame can’t offer.
Medication
This is the biggest practical difference. Sesame lists psychiatrists, psychiatric nurse practitioners and primary care doctors who can evaluate you and prescribe non-controlled medications such as common antidepressants. It does not prescribe controlled substances such as ADHD stimulants or benzodiazepines.
BetterHelp therapists cannot diagnose or prescribe. If you need medication alongside BetterHelp, you’d add a separate prescriber — and Sesame is one option for that.
Choosing a clinician
On BetterHelp you’re matched based on your questionnaire answers, and can switch with a click. On Sesame you pick your own clinician from profiles, patient reviews and open time slots, and same-day visits are often available. People who know what they want in a therapist tend to prefer Sesame; people who don’t want to decide tend to prefer BetterHelp’s matching.
Continuity of care
BetterHelp keeps you with one therapist in a private messaging room, so your history is all in one place. Sesame is a marketplace, so continuity depends on booking the same clinician again. For long-term therapy, BetterHelp’s structure is an advantage; for occasional visits or medication management, Sesame’s flexibility is.
Our verdict
Choose BetterHelp if your goal is regular talk therapy and you like support between sessions. Choose Sesame if you want a prescription, want to pay only when you book, or want to choose your own clinician. Many people use both: BetterHelp for therapy and Sesame for medication.
Neither service is for emergencies. If you are in crisis, call 911 or call or text 988 in the US — see Get Help Now.
Which should you choose?
Choose BetterHelp if…
- You want steady, weekly talk therapy with unlimited messaging between sessions.
- You have Aetna, Cigna, UnitedHealthcare/Optum or a participating Blue Cross Blue Shield plan.
- You’d rather be matched than browse and compare clinicians yourself.
- You want to mix messaging, chat, phone and video sessions.
Choose Sesame if…
- You need a psychiatric evaluation or a prescription for a non-controlled medication.
- You don’t want a subscription and prefer to pay per visit at an upfront price.
- You want to choose your own therapist or prescriber from profiles and reviews.
- You want a same-day appointment, or couples therapy on the same site.
Read the full reviews
- BetterHelp ReviewThe largest online talk-therapy network, matching adults with a licensed therapist for $70–$100 a week or an average $23 copay with eligible insurance. It does not diagnose or prescribe.
- Sesame Care ReviewA cash-price healthcare marketplace where you book therapists, psychiatric clinicians and doctors directly. Mental health visits start around $34, and ongoing medication care costs $79 a month. No insurance needed; no controlled substances.
More provider comparisons
- Talkspace vs. BetterHelpThe two biggest online therapy services, compared on price, insurance, session length, psychiatry, teens and couples, and privacy — with a clear answer on which to choose.
- Talkspace vs. SesameBoth offer online therapy and psychiatry with non-controlled prescriptions. The difference is how you pay — Talkspace through insurance or a weekly plan, Sesame per visit at an upfront cash price.
- BetterHelp vs. PlushCareBetterHelp is a weekly talk-therapy subscription; PlushCare offers per-session video therapy plus online doctors who can prescribe. Here’s how they compare on price, insurance and medication.
- PlushCare vs. SesameBoth offer online therapy and non-controlled prescriptions by video. PlushCare takes insurance; Sesame shows upfront cash prices and lets you choose your clinician.
- BetterHelp vs. LemonaidBetterHelp provides talk therapy but can’t prescribe; Lemonaid prescribes depression and anxiety medication but doesn’t offer therapy. How to decide — and why many people use both.
- Sesame vs. LemonaidTwo low-cost, no-insurance ways to get non-controlled mental health medication online. Sesame’s $79 plan lets you pick your prescriber; Lemonaid’s $95 plan includes delivery and a $25 first month.
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
Is Sesame cheaper than BetterHelp?
Can I get medication through BetterHelp or Sesame?
Can I use BetterHelp and Sesame together?
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 27, 2026
- Last updated
- September 27, 2026
- Last medically reviewed
- Review pending