Provider vs. provider
Talkspace vs. Sesame (2026): Insurance-Covered Care or Upfront Cash Prices?
Talkspace vs. Sesame compared — insurance vs. cash prices, therapy plans vs. pay-per-visit, psychiatry costs, choosing a clinician, teens and couples, and which one suits you.
Our bottom line
Choose Talkspace if you have insurance (including Medicare or TRICARE) or want ongoing therapy with messaging; choose Sesame if you are uninsured or on a high deductible and want cheaper, pay-per-visit psychiatry and refills.
Talkspace vs. Sesame: side by side
| Talkspace | Sesame | |
|---|---|---|
| Type of service | Online therapy and psychiatry | Online therapy, psychiatry and prescriptions |
| 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. | 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 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. | 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) | Yes (non-controlled medications, where clinically appropriate) |
| Ages served | Adults 18+; teens 13–17 with parental consent (therapy only) | Adults for mental health care (Sesame also lists separate pediatric visits) |
| Services | Individual therapy (adults); Teen therapy (ages 13–17, with parental consent); Couples therapy; Psychiatry and medication management (adults); Text, audio and video messaging plus live 30-minute video sessions; Therapist-led workshops (on the top plan) | 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; you are matched with a provider licensed in your state. | Online across the US, with providers listed by state. Sesame says psychiatrists are not available in every state. |
| Links | Visit Talkspace (opens in a new tab)Read our Talkspace review | Visit Sesame (opens in a new tab)Read our Sesame review |
- Type of service
- Online therapy and psychiatry
- 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.
- Prescribes medication
- Yes (non-controlled medications, where clinically appropriate)
- Ages served
- Adults 18+; teens 13–17 with parental consent (therapy only)
- Services
- Individual therapy (adults); Teen therapy (ages 13–17, with parental consent); Couples therapy; Psychiatry and medication management (adults); Text, audio and video messaging plus live 30-minute video sessions; Therapist-led workshops (on the top plan)
- Availability
- Online across the US; you are matched with a provider licensed in your state.
- 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 26, 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
Talkspace and Sesame overlap more than most pairs we compare: both offer online therapy, both offer psychiatry, and both prescribe only non-controlled medications. The real difference is how you pay. Talkspace is built around insurance and weekly plans; Sesame is built around upfront cash prices and paying per visit.
The short answer
- Talkspace is the better choice if you have insurance it accepts, or you want ongoing therapy with messaging.
- Sesame is the better choice if you’re uninsured or on a high deductible — especially for psychiatry and prescription refills.
Cost with and without insurance
| Talkspace | Sesame | |
|---|---|---|
| Therapy (self-pay) | $69–$109 per week | Per visit, set by each therapist |
| Psychiatry (self-pay) | $299 first visit; $175 per follow-up | About $132 per psychiatrist visit on average; $79/month Mental Health Rx |
| Insurance | Plans covering 100+ million Americans, including Medicare and TRICARE | Doesn’t bill insurance |
| Average copay | $10 therapy; $15 psychiatry | — |
| HSA/FSA | Yes | Yes |
If Talkspace is in network for you, it is hard to beat. If it isn’t, Sesame is usually the cheaper route to a prescriber — its $79 monthly plan includes video visits, messaging and ongoing prescriptions, versus $175 per Talkspace follow-up.
Therapy experience
Talkspace pairs you with one therapist and a private messaging room, with live video sessions (30 minutes on self-pay plans). It suits people who want continuous support. Sesame therapy is booked visit by visit with a therapist you choose, and same-day slots are common — better for occasional sessions or for people who want to shop around.
Medication
Both services’ prescribers can evaluate you and prescribe non-controlled medication such as antidepressants. Neither prescribes stimulants or benzodiazepines. Sesame providers may prescribe non-stimulant ADHD medications when appropriate.
Teens and couples
Talkspace offers therapy for teens aged 13–17 with parental consent, plus couples therapy. Sesame lists couples therapy sessions; its mental health services are aimed at adults.
Our verdict
With insurance, choose Talkspace. Without insurance — particularly if you mainly need medication management — choose Sesame. If you want weekly therapy without insurance, compare Talkspace’s plans against booking Sesame therapists individually; the answer depends on how often you want sessions.
Neither is a crisis service. If you need help now, call or text 988 in the US, or see Get Help Now.
Which should you choose?
Choose Talkspace if…
- You have insurance that Talkspace takes — including Medicare or TRICARE — and want a low copay.
- You want ongoing therapy with messaging between sessions.
- You’re looking for therapy for a teen aged 13–17.
- You want your therapist and prescriber on the same platform.
Choose Sesame if…
- You don’t have insurance, or have a high deductible, and want to know the price before booking.
- You mainly need medication management or refills — Sesame’s $79-a-month plan costs far less than Talkspace’s self-pay psychiatry.
- You want to choose your own clinician from profiles and reviews.
- You don’t want a subscription.
Read the full reviews
- Talkspace ReviewAn online therapy and psychiatry service that is in network with plans covering 100+ million Americans, including Medicare and TRICARE. Self-pay therapy costs $69–$109 a week; psychiatry prescribes non-controlled medication.
- 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.
- BetterHelp vs. SesameA weekly therapy subscription versus a cash-price marketplace for therapy, psychiatry and refills. How BetterHelp and Sesame compare on cost, choice of clinician and medication.
- Talkspace vs. PlushCareBoth take insurance and can prescribe non-controlled medication. Talkspace is a mental-health specialist with messaging therapy and psychiatry; PlushCare is a medical practice with per-session video therapy.
- 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.
- Talkspace vs. LemonaidBoth can prescribe non-controlled medication for depression and anxiety. Talkspace adds therapy and takes insurance; Lemonaid is a low flat monthly price for medication only.
- 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 Talkspace?
Do Talkspace and Sesame prescribe ADHD medication?
Which is better for ongoing therapy?
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