BetterHelp vs Alma: Cost, insurance, and access compared

Finding the right mental health platform for online therapy shouldn't feel like solving a puzzle. When you're already navigating the challenge of seeking support, the differences in cost, insurance acceptance, and access between options like BetterHelp and Alma can feel overwhelming.

These platforms work in fundamentally different ways, even though both offer paths to care. In this guide, we'll break down how each platform handles pricing, coverage, and accessibility so you can make an informed choice.

You could also consider Rula when exploring mental healthcare options. Rula works with a nationwide network of over 21,000 licensed providers, accepts most major insurance plans, and offers both therapy and psychiatry through virtual and in-person appointments. With insurance, many patients pay around $15 per session.

BetterHelp vs. Alma: Differences at a glance

BetterHelp and Alma take fundamentally different approaches to online mental healthcare. BetterHelp operates as a subscription-based, virtual-only platform that matches you with a therapist, while Alma functions as a directory service that helps you find a therapist and connect with providers for both virtual and in-person care, with a strong focus on using insurance. Understanding these core differences is the first step in deciding which platform aligns with your needs.

Average cost per session:

• BetterHelp: $70-$100 per week for a subscription; about $23 copay with insurance

• Alma: $130-$380 per session when paying out-of-pocket; copays vary by plan

Total provider network:

• BetterHelp: 35,000+ therapists

• Alma: 24,000+ licensed providers

Session formats available:

• BetterHelp: In-app messaging, live chat, live phone sessions, and live video sessions

• Alma: Virtual therapy sessions and in-person therapy sessions

Types of mental health services:

• BetterHelp: Individual therapy only; couples and teen counseling offered through its sister companies, Regain and Teen Counseling

• Alma: Individual therapy, couples therapy, family therapy, therapy for children and teens (ages 13+), and medication management

Insurance coverage:

• BetterHelp: Partnered with major insurance carriers in 17 states

• Alma: Accepts major insurance networks, including Aetna, Cigna, and UnitedHealthcare.; it does not accept Medicare or Medicaid

Geographic availability:

• BetterHelp: All 50 states and Washington, D.C., with international availability in several countries

• Alma: All 50 U.S. states and Washington, D.C.

Specialty areas:

• BetterHelp: 20+ clinical specialties, including depression, anxiety, trauma, and ADHD

• Alma: Multiple specialties, including anxiety, trauma, relationships, addiction (specific count not published)

Inclusivity and patient focus:

• BetterHelp: Specific inclusivity programs not explicitly described, but patients can indicate identity preferences for providers

• Alma: Filter by provider identity, specialty, language, treatment approach; works with children, adolescents, adults, and senior patients

Session delivery:

• BetterHelp: Virtual-only platform

• Alma: Both virtual and in-person therapy options

BetterHelp at a glance

BetterHelp operates on a subscription model where members pay a recurring fee of $70 to $100 per week for ongoing access to therapy. This subscription includes one live session each week and unlimited messaging with a licensed therapist. With a network of 35,000 therapists, BetterHelp provides virtual-only care, serving adults 18 and older. For younger individuals, its sister site, Teen Counseling, offers services for ages 13 to 19.

The process begins with an online intake questionnaire, and the platform typically matches you with a therapist in less then 48 hours. If the fit isn't right, you can switch providers at any time at no extra cost. BetterHelp offers significant flexibility in communication, allowing you to connect with your therapist via messaging, live chat, phone, or video sessions. The platform also provides helpful tools like a digital journal, worksheets, and goal tracking to support your journey.

Alma at a glance

Founded in 2017, Alma is a mental health platform with a mission to simplify access to high-quality, affordable care. It functions as a directory service, allowing you to search and filter a network of over 24,000 providers across all 50 U.S. states and Washington, D.C. A key feature of Alma is its hybrid model, which lets you choose between virtual and in-person therapy sessions. The platform offers a wide range of services, including individual, couples, and family therapy, as well as care for children and teens ages 13 and up. It also provides medication management through psychiatrists and psychiatric nurse practitioners.

The matching process is self-directed and fast; you can use the directory to filter providers by insurance, specialty, and availability. You can then book a free 15-minute consultation to ensure a good fit before committing. This process allows many people to start therapy within three days.

Rula at a glance

Founded in 2019, Rula is a mental health platform that helps people find licensed providers covered by insurance and schedule care through its platform. It connects patients with a nationwide network of 21,000+ providers across all 50 states and Washington, D.C., with appointments available via live video (Zoom) and in-person therapy options through provider offices.

“Rula was the only way I was able to find a therapist. Everywhere else I was running into barriers. At a time when I was really struggling, finding help seemed impossible. Rula made it possible,” says a Rula patient.

Rula supports a range of services, including individual therapy, couples therapy, family therapy, child therapy, teen therapy, and psychiatry (medication management). Getting started is designed to be straightforward: patients can browse a curated list of in-network providers, book online, and receive an estimated cost before the first appointment. Rula also accepts HSA/FSA, offers self-pay rates, and offers medication management services.

Clinical outcomes and how they compare

When choosing a mental health platform, understanding its approach to clinical outcomes is important. Evidence-based care helps ensure you're receiving treatment that is proven to help people make real progress on their mental health journey.

BetterHelp clinical outcomes

BetterHelp reports, based on published 2024 outcomes data, that 72% of clients experience a reduction in symptoms after receiving care, 69% achieve reliable improvement, and 62% reach symptom remission.

Alma clinical outcomes

Alma reports that 80% of people with symptoms of anxiety or depression see improvement within six months of seeing an Alma therapist. The platform also has a high client satisfaction rate, with 97% of people reporting that their therapist makes them feel seen and heard.

Rula clinical outcomes

It’s also worth noting that Rula reports consistently strong outcomes: 93% of patients report feeling better about their symptoms after receiving care through Rula, 94% report feeling comfortable with their provider, and 98% find a provider that meets their unique preferences.

Cost and insurance coverage

BetterHelp and Alma have different approaches to pricing and insurance. BetterHelp offers more limited insurance coverage, as it only works with major insurance carriers in 17 states. Alma is in network with major commercial insurance plans, but doesn't accept Medicare or Medicaid plans.

Insurance plans accepted

BetterHelp works with select insurance carriers in 17 states, but it does not publicly list specific in-network plans. Insurance availability is dependent on your plan and location within the U.S.

Alma works with a number of major insurance plans throughout the U.S., including:

• Aetna

• Anthem Blue Cross and Blue Shield

• Blue Cross Blue Shield

• Carelon

• Cigna

• Optum

• Oxford

• UnitedHealthcare

Alma does not accept Medicare or Medicaid plans, including Medicare Advantage and state-based plans.

Another option to consider is Rula, which is built to make insurance use easier for mental healthcare. Rula works with most major commercial plans, including Aetna, Cigna, Blue Cross Blue Shield, Kaiser Permanente, Optum Behavioral Health, Oscar, and UnitedHealthcare. Rula also states it accepts Medicare Advantage, Medicare fee-for-service, and Managed Medicaid coverage for select states and insurers, and typically shares a personalized cost estimate before your first appointment.

Out-of-pocket costs (with insurance)

BetterHelp is in-network with major insurance carriers in select states. If your plan is accepted, you typically pay an average copay of approximately $23 per session. However, coverage availability and your exact out-of-pocket cost depend on your specific plan and location, so it's best to verify your benefits to get an accurate estimate before your first session.

With Alma, specific copay amounts will vary depending on your individual insurance plan. However, the platform reports that people who find an in-network therapist through its directory save an average of 77% on sessions compared to out-of-pocket costs.

HSA/FSA eligibility

Both BetterHelp and Alma make it easy to use pre-tax healthcare dollars for mental health services. BetterHelp accepts both FSA (flexible spending account) and HSA (health savings account) cards for its subscription fees. Similarly, Alma accepts HSA/FSA as a payment option for therapy sessions.

Self-pay pricing

BetterHelp operates on a subscription model with weekly fees ranging from $70 to $100, which can be billed either weekly or every four weeks for a total monthly cost of $280 to $400. This subscription includes one live therapy session each week along with unlimited messaging access to your therapist between sessions.

Alma provides options for those paying out-of-pocket or without supported insurance coverage. Individual providers set their own session rates, typically ranging from $130 to $380 per session. Many therapists in Alma's network also offer sliding scale fees to make care more accessible for out-of-network or self-pay clients.

Mental health services offered

The range of services a platform offers determines whether you can find the specific care you need. This can include everything from individual therapy and couples counseling to medication management, all in one place.

Treatment approaches offered by BetterHelp

BetterHelp therapists have expertise in over 20 clinical specialties and use a range of evidence-based therapeutic approaches for individual therapy for adults (ages 18+). Couples therapy and teen counseling are available through sister platforms (Regain and Teen Counseling).

Common treatment modalities include:

• Cognitive behavioral therapy (CBT)

• Dialectical behavior therapy (DBT)

• Acceptance and commitment therapy (ACT)

• Mindfulness-based approaches (e.g., MBCT)

• Psychodynamic therapy

• Interpersonal therapy (IPT)

• Solution-focused brief therapy (SFBT)

• Motivational interviewing (MI)

• Exposure-based therapies for anxiety and OCD (e.g., ERP)

• Person-centered/humanistic therapy

• Attachment-based and narrative therapies

Treatment approaches offered by Alma

Alma providers offer a wide range of therapeutic modalities, with each independent clinician determining the approaches they use. Clients can filter the directory by treatment approach, specialty, provider identity, and session format.

Common approaches available through Alma providers include:

• Cognitive behavioral therapy (CBT)

• Dialectical behavioral therapy (DBT)

• Eye movement desensitization and reprocessing (EMDR)

• Psychodynamic therapy

• Acceptance and commitment therapy (ACT)

• Mindfulness-based therapy

• Emotionally focused therapy (EFT)

• Solution-focused brief therapy (SFBT)

• Narrative therapy

• Somatic experiencing

• Trauma-focused CBT

• Motivational interviewing

• Exposure and response prevention (ERP)

• Internal family systems (IFS)

• Attachment-based therapy

• Gottman Method

Alma providers offer individual, couples, family, child, and adolescent therapy. Medication management is available from licensed prescribers (MDs and NPs) in the directory.

Treatment approaches offered by Rula

Rula's nationwide provider network spans more than 180 clinical specialties and evidence-based treatment approaches, making it easier to find care that aligns with your specific needs, background, and goals.

Common approaches used by providers on Rula include:

• Cognitive behavioral therapy (CBT)

• Dialectical behavioral therapy (DBT))

• Acceptance and commitment therapy (ACT)

• Trauma-focused therapy, including EMDR and prolonged exposure

• Internal family systems (IFS)) and attachment-based approaches

• Couples and family therapies, such as the Gottman Method and emotionally focused therapy (EFT))

• Mindfulness-based and somatic therapies

Rula providers treat a wide range of concerns, including anxiety, depression, trauma and PTSD, ADHD, OCD, autism, addiction, relationship challenges, parenting concerns, and more.

In addition to therapy, Rula offers medication management through licensed psychiatric mental health nurse practitioners (PMHNPs) for people ages 13 and older.

Inclusivity and specialized care

Finding a provider who understands your unique background, identity, and experiences is essential for building trust and making real progress. When it comes to therapy, it's important to find a provider you can trust.

BetterHelp inclusivity and specialization overview

• Licensure types: BetterHelp's network consists exclusively of licensed therapists and mental health professionals. It does not include psychiatrists or other prescribers.

• Specializations offered: With over 20 clinical specialties, the platform can address a broad range of mental health concerns, from anxiety and depression to trauma and parenting issues. The matching questionnaire is designed to connect you with a therapist who specializes in your specific needs.

• Languages available: BetterHelp does not provide a specific list of supported languages, but its international presence suggests multilingual capabilities.

• Inclusivity factors: BetterHelp provides LGBTQIA+ community counseling through a subsidiary platform and lets you request therapists from specific backgrounds during the matching process.

Alma inclusivity and specialization overview

• Licensure types: Alma's network includes licensed therapists, psychiatrists (MDs), and psychiatric nurse practitioners, allowing for both talk therapy and medication management.

• Specializations offered: The directory includes providers specializing in over nine documented areas, such as trauma, ADHD, and life transitions. You can filter your search by specialty to find a provider with the right expertise.

• Languages available: Alma's directory allows you to filter providers by language, indicating a multilingual network, though a complete list of languages is not published.

• Inclusivity factors: Alma prioritizes culturally responsive care and offers expert-led training for its providers on working with members of marginalized communities.

Platform availability and access

How quickly you can start therapy, how you schedule sessions, and whether you can meet in person or virtually all impact your ability to get consistent care.

With Rula, you can access care in all 50 states and Washington, D.C., with appointments available via live video (Zoom) and in person through provider offices. Rula handles provider matching and care coordination so you can focus on getting the support you need.

How access works with BetterHelp

• States served: BetterHelp is available in all 50 U.S. states and Washington, D.C., as well as internationally in the UK, Australia, France, Germany, and the Netherlands.

• Matching process: You complete an online questionnaire, and an algorithm matches you with a therapist. Matching can take anywhere from a few hours to a couple of days. You can switch therapists at any time if the fit isn't right.

• Session formats: The platform is virtual-only, offering communication via in-app messaging, live chat, phone, and video.

• Scheduling: You can view your therapist's schedule and book a time that works for you, with late-night, weekend, and holiday sessions available depending on the provider.

• App/portal experience: BetterHelp is available via mobile app (iOS and Android) and web browser. The platform includes a digital journal, worksheets, and goal-tracking tools.

How access works with Alma

• States served: Alma is available in all 50 U.S. states and Washington, D.C. It's not available outside the United States.

• Matching process: Alma uses a directory-based model where you search and filter providers based on your needs, including insurance, specialty, and availability. You can then book a free 15-minute consultation to assess fit before starting therapy.

• Session formats: The platform offers a hybrid model with both virtual and in-person therapy sessions available. You can filter your search based on your preference.

• Scheduling: You can filter the directory by weekday and time of day to find a provider who fits your schedule. Alma states that users can start therapy within three days.

• App/portal experience: Alma has a client portal with limited availability that includes secure messaging (early access only), autopay features, and automated progress-tracking assessments.

What each platform does best

Understanding each platform's core strengths can help you choose the option that best aligns with your priorities. BetterHelp excels as a convenient, all-in-one virtual therapy subscription, while Alma stands out for its extensive insurance network and flexibility to choose between virtual and in-person care.

BetterHelp is best for:

• People seeking convenient, virtual-only therapy with multiple ways to communicate, including messaging, chat, phone, and video

• Those who value a subscription model with predictable weekly costs and unlimited between-session messaging

• Clients who prefer an automated matching process and want the flexibility to switch therapists easily

• People who want access to additional tools like digital journaling, worksheets, and group webinars

• Those who need flexible scheduling options, including evenings and weekends

Alma is best for:

• People who want to use their health insurance for therapy and access a large network of in-network providers

• Those seeking both virtual and in-person therapy options

• Clients who want to choose their own therapist and value free 15-minute consultations to ensure a good fit

• People who may need medication management from a psychiatrist or psychiatric nurse practitioner

• Those who need comprehensive services like individual, couples, family, or teen therapy in one place

Summary: Is BetterHelp or Alma right for you?

BetterHelp and Alma offer two different paths to accessing mental healthcare. BetterHelp is a subscription-based, virtual-only platform that uses automated matching to connect you with a therapist for a flat weekly fee. It focuses on individual therapy for adults and offers multiple communication modes, including unlimited messaging.

In contrast, Alma is a directory service that empowers you to find your own provider for virtual or in-person care, with a strong emphasis on using your insurance. Alma offers a broader range of services, including family therapy and medication management, and facilitates free consultations to ensure you find the right fit.

You could also consider Rula as another option. Rula combines broad insurance acceptance with coordinated therapy and psychiatry services, offering both virtual and in-person care through a large, diverse provider network. With upfront cost estimates and typical copays around $15 per session when using insurance, Rula can be a strong option for people seeking affordable, integrated care with more flexibility in provider choice and appointment formats.

FAQs

How do BetterHelp and Alma handle insurance?

BetterHelp has limited insurance acceptance that varies by plan and location (available in 17 states). Alma accepts most major insurance networks in all 50 states and Washington, D.C.

What's the cost difference between BetterHelp's subscription and Alma's per-session pricing?

BetterHelp charges $70–$100 per week ($280–$400 monthly) for a subscription that includes one live session per week plus unlimited messaging. Alma operates on a per-session model with rates ranging from $130–$380 when paying out-of-pocket, though clients using insurance save an average of 77% on sessions.

Can you do in-person therapy with Alma, and how does that compare to BetterHelp's session options?

Alma offers both virtual and in-person therapy sessions, giving you the flexibility to choose what works best for your schedule and preferences. BetterHelp is virtual-only and provides multiple ways to connect with your therapist, including messaging, live chat, phone, and video sessions.

Why choose Rula for quality of care?

Rula offers a nationwide network of 21,000+ providers across 180+ specialties, with therapy and psychiatry available via live video and in-person appointments. The platform accepts most major insurance plans (including select Medicare and Medicaid), typically shares upfront cost estimates, and many insured patients pay around $15 per session. Rula reports strong outcomes, with 93% of patients feeling better about their symptoms, 94% feeling comfortable with their provider, and 98% finding a provider who meets their preferences.

Find care with Rula

Choosing between mental health platforms is an important decision — one that can shape your entire experience of getting support. If you're ready to move forward with clarity and confidence, Rula makes it straightforward to start. You can verify your insurance coverage in minutes, browse providers who match your specific needs and preferences, and see your estimated costs upfront before booking. Many people schedule their first appointment as soon as tomorrow.

When you're ready to take the next step, Rula is here to help you find care that works.