Thriveworks vs. BetterHelp: Key differences in cost, care, and client experience

Thriveworks vs. BetterHelp at a glance

How each platform works in practice

Thriveworks

Thriveworks offers both virtual and in-person therapy in 49 states and Washington, D.C. Vermont is the only state not covered. Psychiatry services are available in 27 states and Washington D.C., primarily online, with in-person psychiatric care available in select states.

One thing that sets Thriveworks apart from most online therapy platforms is that you choose your own provider. You can browse by specialty, insurance, therapeutic approach, and availability, then book directly with the person who seems like the right fit. If it’s not working out, you can switch to someone else at any time—no fees, no questions, no waiting for an algorithm to reassign you.

Most new clients are seen within one week, with same-day availability in some cases. Sessions happen in real time—video or in person—and communication with your provider happens within sessions only, though some providers may offer their email address for direct communication if needed. Between-session messaging is not formally offered, which is worth knowing upfront if that’s something you’d want.

Two things are worth understanding about how Thriveworks approaches care that you won’t find on most platforms. First, all clinicians are employed directly by Thriveworks. They’re not independent contractors or gig workers. That means Thriveworks can hold every provider to consistent clinical standards and invest in their ongoing training. Your therapist isn’t splitting their attention across multiple platforms; they’re focused entirely on their Thriveworks clients.

The other is measurement-based care. Your provider regularly uses clinically validated assessments—the PHQ-9 for depression, GAD-7 for anxiety, and ARM-5 for therapeutic alliance—to track your progress over time. This means your care isn’t based on gut feeling alone. If something isn’t working, the data reflects it, and your provider can adjust accordingly. Most online therapy platforms don’t do this.

One practical note on scheduling: There’s a $135 late cancellation fee for cancellations made within 48 hours of your session. Changes are easy to make through your online account, just make sure you do it with enough notice to avoid the charge.

BetterHelp

BetterHelp is fully app-based and available nationwide. To get started, you complete a questionnaire and an algorithm matches you with a therapist. The average time to matching is 24–48 hours. Note that’s time to match, not necessarily time to your first session, which may take longer depending on your therapist’s availability.

If the match isn’t right, you can request a new one, but the process repeats: another questionnaire, another algorithm match. You don’t browse or self-select.

BetterHelp operates on a subscription model—$260 to $400 per month—which includes one live session per week (30 or 45 minutes) plus a set of additional features that are genuinely useful for some people: unlimited messaging with your therapist between sessions, therapist-assigned worksheets, a built-in journal, access to mental health webinars, and optional group sessions. If you’d use those extras regularly, the subscription model has real value. If you’d mainly use it for weekly sessions, the per-session math may not work in your favor compared to using insurance elsewhere.

BetterHelp therapists are independent contractors, not employees, which means BetterHelp has less direct oversight over clinical standards than a platform with employed providers.

The late cancellation fee is $15 for cancellations within 24 hours—significantly lower than Thriveworks, and with a shorter notice window required.

Services and specialties

Thriveworks

Thriveworks offers individual therapy, couples and marriage therapy, family therapy, and child and teen therapy—all available to book through the same platform. Psychiatric care and medication management are also available in many states, and uniquely, your therapist and psychiatric provider can work as a team to coordinate your care.

Thriveworks providers cover a wide range of specialties, from anxiety and depression to trauma, eating disorders, ADHD, grief, and more. You can browse the full list when searching for a provider, which makes it easier to find someone who matches your needs and preferences.

BetterHelp

BetterHelp’s primary focus is individual therapy for adults. Couples therapy and teen therapy are available, but through separate platforms: Regain.us and TeenCounseling.com, respectively. If you’re looking for a single platform to handle multiple needs, it’s worth checking how seamlessly these connect before signing up.

BetterHelp doesn’t list provider specialties the way Thriveworks does. Instead, the site lists therapeutic approaches—CBT, EMDR, IFS, and others—but you won’t be able to vet a provider’s specific areas of focus before being matched.

Psychiatry and medication management are not available through BetterHelp.

Cost, insurance, and what you'll actually pay

Does Thriveworks accept insurance?

Yes. Thriveworks is in-network with more insurance plans than any other national mental health provider,* making it one of the most accessible options for anyone who wants to use their coverage. More than 360 plans are accepted, including most major carriers:

• UnitedHealthcare
• Humana
• BlueCross BlueShield
• Aetna
• Cigna
• Optum
• Anthem
• Tricare
• Ambetter
• Medicare
• And many more

With insurance, most clients pay $0 to $55 per session in copays. If your plan isn’t accepted or you prefer not to use insurance, self-pay rates are:

• $200–$240 for an initial therapy session
• $160–$195 for follow-up therapy sessions
• $300–$375 for an initial psychiatry appointment
• $210–$300 for psychiatry follow-ups

For full details on insurance and pricing, visit our insurance and pricing page.

How BetterHelp pricing works

BetterHelp’s primary payment model is a monthly subscription ranging from $260 to $400, which includes one live session per week plus extras like between-session messaging, worksheets, a journal, group sessions, and webinars. Additional sessions beyond the weekly one are available for an extra cost.

In select states, some BetterHelp therapists are credentialed with certain insurance plans, but availability varies by provider and location. For those who do qualify, there is no subscription fee under the insurance model. Instead, you pay only per completed session based on your copay, with an average of $23 per session. Note that insurance currently covers video sessions only. Between-session messaging remains available but is not billed as a session. It’s also worth noting that BetterHelp’s pricing varies by location. The platform has confirmed it charges more in areas where demand for mental health care is higher.

To find out if your plan is accepted, BetterHelp recommends creating a new account and selecting “Pay with insurance” during the questionnaire. The system will run an eligibility check automatically.

Per-session vs. subscription: What to consider

The right model depends less on which platform sounds better and more on how you actually plan to use it. It’s worth knowing that both models exist within BetterHelp itself, though the insurance-based per-session option is only available to a limited subset of users depending on location and provider availability.

If you have insurance and want to use it, the per-session model at Thriveworks will almost always be the more cost-effective choice. Most clients pay $50 or less per session, and you’re only paying for sessions you actually attend. If you want flexibility to go every other week, take a break, or step down frequency as you make progress, per-session gives you that without any penalty.

The subscription model makes more sense if you don’t have insurance or prefer not to use it, you know you want to meet weekly, and you’d genuinely use the extras, particularly between-session messaging. For someone who wants ongoing access to their therapist between appointments, that feature alone can justify the monthly cost. The key question to ask yourself: Would I actually use the messaging and other tools, or am I mainly here for the weekly session?

Client outcomes and reviews

Thriveworks

According to internal Thriveworks data, four out of five clients return for a second session—a strong signal that the first experience lands well. Among clients tracking symptoms over time, three out of four people dealing with depression or anxiety report feeling better within three months.

On the therapeutic relationship itself, 96% of clients feel truly supported and understood by their therapist, and 96% feel confident their therapist can help them reach their goals (ARM-5 internal data).

Independent research backs this up. HelpGuide’s survey found that about 80% of Thriveworks users said the service helped them make good or very good progress toward their goals, and 95% of people using Thriveworks’ psychiatry services said they were satisfied or very satisfied. As of March 2026, Thriveworks is rated 4.5 stars from 26,350+ Google reviews across 330+ locations nationwide.

BetterHelp

BetterHelp holds a 4 out of 5 rating on Trustpilot based on roughly 9,300 reviews, and HelpGuide’s independent review rated it 4.8 out of 5 stars, with 86% of users saying they would use BetterHelp again.

If you’ve come across concerns about BetterHelp’s data privacy practices, here’s what happened: In 2023, the FTC charged BetterHelp with sharing users’ private health information—including data disclosed during the intake process—with platforms like Facebook, Snapchat, and Pinterest for advertising purposes. The case resulted in a $7.8 million settlement. BetterHelp has since updated its privacy practices. You can read the full FTC statement here.

Which is right for you?

If you’ve made it this far, you probably have a pretty good sense of which direction you’re leaning. Here’s a final framework to help you decide.

Consider Thriveworks if:

• You have insurance and want to use it. Most clients pay $50 or less per session.
• You want to choose your own provider and switch anytime, for free, without starting over.
• You want the option of seeing someone in person, not just online.
• You need psychiatric care or medication management alongside therapy.
• You’re looking for care that tracks your progress over time with clinically validated tools.
• You want a range of services—couples, family, child and teen therapy—all in one place.

BetterHelp may be a better fit if:

• You don’t have insurance or prefer not to use it.
• You want to be able to message your therapist between sessions. For some people, that ongoing access is valuable.
• You’d use the extras (worksheets, group sessions, journaling) and want them bundled into a predictable monthly cost.
• You prefer a fully app-based experience with no in-person component.

Whichever platform you choose, the most important thing is that you’re taking the step. If Thriveworks feels like the right fit, we’d love to help you get started.

Frequently asked questions (FAQ)

Does BetterHelp take insurance?

BetterHelp accepts insurance in select states through select providers, but coverage is limited and not available to most users. For those who qualify, there is no subscription fee. You pay only per completed session, with an average copay of $23. To check eligibility, BetterHelp recommends creating a new account and selecting “Pay with insurance” during the sign-up questionnaire.

Does Thriveworks accept insurance?

Yes, Thriveworks is in-network with more insurance plans than any other national mental health provider,* accepting 360+ plans covering more than 215 million Americans. Most clients pay $50 or less per session. Visit our insurance and pricing page for full details including self-pay rates.

Can I get medication through BetterHelp?

No. BetterHelp focuses exclusively on talk therapy and does not offer psychiatry or medication management.

Is Thriveworks available online?

Yes, Thriveworks offers virtual therapy in 49 states and Washington, D.C. You can choose between online sessions and in-person care depending on your preference and location.

Is BetterHelp private?

If you’ve come across concerns about BetterHelp’s privacy practices, here’s the background: In 2023, the FTC charged BetterHelp with sharing users’ private health information with platforms including Facebook, Snapchat, and Pinterest for advertising purposes, resulting in a $7.8 million settlement. BetterHelp has since updated its privacy practices. You can read the full FTC statement at ftc.gov.

*Based on an independent analysis of national insurance claims data comparing in-network participation across leading mental health providers. Analysis included a defined set of major behavioral health providers and commercial payers, using standard rate-based methods to identify in-network relationships.