Almost everyone I know is thinking about therapy these days. Mental health services are always vital and more and more people are seeking these services for emotional support.
As a result, online therapy is having a moment. Remote providers are easier to access while maintaining physical distancing, and virtual appointments fit into busy schedules. Even after the pandemic subsides, online mental health treatment is probably here to stay, so these services are definitely worth checking out.
And for many clients, this treatment is surprisingly affordable. Online counselors — who have the same credentials and expertise — tend to charge much less than in-person counselors. This is good news for anyone who thinks they don’t have the money for mental health care; there are services for every budget and insurance plan. You don’t need an official diagnosis, and often you don’t even need health insurance coverage to get a reasonable price.
How do online mental health services work?
You’ll typically visit a provider website and complete a free questionnaire or assessment where you give more information about the reasons you’re seeking therapy. The site uses this info to match you with a professional in their provider network who has the kind of experience you need. Any details you provide are kept confidential — you don’t even have to reveal your real name to the therapist if you don’t want to. A few providers like eTherapyPro will give you a short free trial before you commit.
With most providers, you can make requests, like opting for a therapist who shares your gender identity or specializes in treating a certain condition. And you’re able to switch therapists if you don’t find a fit right away.
Each program operates the therapy sessions a little differently: you and your provider may talk over text messages, in a secure chat room, or through audio and video chats. Services may charge additional fees for higher-contact sessions like video chats and live talks. But they’re transparent about their prices before you pay, so you shouldn’t be blindsided by extra charges.
Which mental health services are available online?
Remote talk therapy can tackle just about any problem you’d take to an in-person therapist, from depression and anxiety to trauma and grief.
Some online providers have niches, like Regain for relationship counseling and Pride Counseling for issues specific to the LGBTQ+ community. Others provide the option of group therapy. If you know a method of therapy that’s worked well for you in the past, you can explore online options — Online-Therapy.com, for instance, specializes in cognitive behavioral therapy.
Psychiatry and medication management are a little trickier to find online — therapists don’t typically prescribe medications, so you’ll go through a psychiatrist or primary care provider if meds are part of your treatment plan. Doctor on Demand and MDLive are two of the best-known mental health services that also have psychiatrists in their wheelhouse who can write or renew prescriptions. You may have to wait a while to get a psychiatry appointment, depending on demand.
And each service selects therapists and other health care providers who have licenses and clinical training — if you’re paying for therapy, you’ll get a licensed therapist (at least you should). Sites like 7 Cups of Tea offer online support groups you can attend for free, but the tradeoff is you won’t be working with professionals.
What do online mental health providers charge?
The cost depends on several factors, like how long and how often you want treatment. With some providers you’ll pay per session; with others, you’ll pay upfront for a subscription plan that covers a predetermined time period or amount of sessions. All of Talkspace’s plans, for example, allow you to send unlimited messages to a therapist who replies daily.
Services with a higher sticker price, such as Doctor on Demand, usually accept insurance — so your insurance plan may pick up some of the bill. Services that don’t accept insurance may have lower prices, allowing more people to pay out of pocket.
Here’s a quick look at some platforms and their pricing plans:
Platform Cost Accepts insurance
Talkspace $260-$396/month, or $708-$1068 per quarter (three months). Pricier plans include live chat sessions, which can also be paid for individually at $65/session. Yes
BetterHelp $80-$100/week, billed monthly No
Online-Therapy.com $32-$64/week No
Doctor On Demand $129-$179/therapy session, $299/psychiatry session Yes
MDLive $99/therapy session, $284/first psychiatry session, $108/psychiatry follow-up Yes
Amwell $99-$110/session Yes
Regain $60-$80/week No
Pride Counseling $80-$100/week No
7 Cups of Tea $150/month for individual therapy, free for support groups/chat rooms No
Higher prices indicate higher levels of support — more frequent sessions or replies from therapists, or live chats in real-time. Subscription-based services usually let you choose whether you want to be billed weekly, monthly, or quarterly, and let you change or cancel your plan any time. It’s often cheaper to pay upfront for the longest amount of time you can afford if you think you’ll need long-term therapy.
On average, you could pay as little as $30 for a 45-minute therapy appointment, or between $40-$60 for ongoing messages with a therapist throughout the week. The Open Path Psychotherapy Collective is one resource that keeps a running list of licensed providers charging $30-$60 per session. That’s about the same as a modest copay for an in-person appointment after insurance, and in high-cost areas where health care is more expensive, it’s a significant savings.
Can remote providers save you money?
Compared to an in-person counselor, an online counselor will be a more affordable option for a lot of people. This isn’t always the case, since depending on your location and insurance plan you may pay roughly the same amount for face-to-face and online visits.
Typically, though, in-person therapy with a private practitioner costs between $100-$200 per hour-long appointment before insurance kicks in. Even if insurance foots part of the bill, you’re still paying more than you would for virtual appointments.
Another bonus to remote mental health care is price transparency and consistency, something woefully absent from most health services here in the United States. While face-to-face providers charge more in places where the cost of living is higher, online providers charge the same amount no matter where you live. And their sites clarify upfront how much you’ll be charged and which services your payments will cover.
Are there free online mental health resources?
While you have to pay for access to a licensed professional therapist, plenty of free services online can provide helpful emotional support or give you techniques to use on your own.
- The online counseling site 7 Cups of Tea offers free support from trained volunteers, including chat rooms that run 24/7. You can join for free or upgrade to a paid membership for sessions with a licensed counselor.
- If you find support groups helpful, sites like Mental Health America can point you to groups (in-person and online) tailored to almost every mental health need.
- If you’re more of a self-starter, the Centre for Interactive Mental Health Solutions has a free eight-session interactive program that uses cognitive behavioral therapy methods.
- If you just need to chat with someone on a temporary basis, the National Alliance on Mental Illness has a free phone helpline and multiple “warmlines” staffed by trained volunteers all over the country.
- Depending on your financial situation, a local health resource center may be able to set you up with low-cost or free treatment, including virtual therapy. Find a center near you here.
Will health insurance cover online treatments?
Most insurance plans cover mental health treatments — for plans offered through the Affordable Care Act this coverage is required — and since COVID-19 hit, more insurers are extending coverage to include online therapy and psychiatry.
Just make sure you read the fine print when it comes time to choose your health insurance plan, as each plan has its own limits and exclusions. Some insurers might only cover live video sessions (not text messaging sessions), or require evidence the treatment is medically necessary, such as a doctor’s referral. If you have insurance, check the fine print to see which remote services are covered and how to get reimbursed.
Unfortunately, many online therapy providers don’t accept insurance at all. Choosing one of these providers may make sense if you’re not covered by insurance, your plan won’t pay for online therapists, or you only need short-term treatment —but you should budget for out-of-pocket payments. If you have a health savings account (HSA) to help with expenses, that’s even better.
Most services have options for payment plans, and since providers that don’t take insurance tend to have lower sticker prices, you might end up paying about as much as you would for a co-pay under a covered provider.
What to look for in a remote mental health provider
Find someone who’s licensed
If you’re working with someone one-on-one, they should be formally qualified (therapists’ education and experience bona fides are often listed on provider websites). Most online providers clearly state they only work with licensed professionals.
Also, the therapist should be licensed to practice in the state where you live, even if they’re treating you from another state.
Look for specialized expertise if necessary
The breadth of remote providers means you’re likely to find experts trained to deal with just about any specific condition.
Ensure your privacy is protected
Remote services should be compliant with HIPAA, the Health Insurance Portability and Accountability Act, which mandates the info you provide in therapy is kept confidential. This is especially crucial with online services. Sites should explain how they protect or encrypt any messages or chats you and your therapist send.
See how flexible payment options are
Ideally, you should know upfront what you’re paying for — no hidden charges — and be able to switch to a higher- or lower-tier payment plan if your situation changes.
How to find the right online therapist for you
Determine your needs
The best treatment plan depends on what you’re looking for in therapy. Do you want a brief consultation to work through a temporary issue or a longer ongoing relationship? Is talk therapy sufficient or do you need someone to provide medication? Has a certain type of treatment, like CBT, worked well for you previously? It might help to write down your goals for treatment, including what you hope will change.
If the online service starts with a free initial assessment (most of them do) be as honest and forthcoming as possible.
Estimate how long and how often you want therapy
A lot of providers start you out with a choice of subscription plans — as a rule, the more you interact with your therapist, the more you’ll pay.
If you anticipate needing a level of treatment that doesn’t fit into your budget, it’s worth shopping around to compare different remote providers, since their pricing plans vary. Or choose a service that lets you pay per appointment, which might be more manageable.
You may also want to start small by picking a low-cost plan to get you started, and gradually save for a higher-priced treatment plan in the future if you need it.
Pick your format
If you prefer one method of online communication over another (I like text messages because I have mild hearing loss) find a provider who offers this format, preferably at no additional cost. Your health insurance may also specify the formats it’s willing to cover.
Take advantage of trial periods
The first website or therapist you try might not be the best one for you, so use any free trial periods to think about whether you’d like to continue with the service before you put money down. Most services will let you switch therapists with no financial penalty, even after you’ve paid.
Online mental health resources are available for a range of budgets, so don’t let cost or accessibility stand between you and therapy. Mental health keeps you functioning, just like physical health, and it’s worth investing in.