Charlie Health is a virtual intensive outpatient program (IOP): roughly 9 to 12 hours of treatment a week, in about 40 states, with no Medicare. Most alternatives here offer standard outpatient care instead.
Rula offers therapy and psychiatry in all 50 states, with Medicare everywhere and Medicaid in select states. The average copay is about $15, and visits can start the next day.
For more intensity, Brightside and Sandstone Care come closest. Brightside runs a Crisis Care program, and Sandstone adds a partial hospitalization program (PHP), residential, and detox.
Match your level of care first, then compare insurance, ages served, and format. A step-down from an IOP has different needs than weekly teen therapy.
The best Charlie Health alternatives include Rula, with insurance-based therapy and psychiatry and Medicare in all 50 states; Brightside, built for higher-acuity depression, anxiety, and suicide-risk care; and Sandstone Care, for in-person, higher-intensity teen and young-adult treatment. Match your level of care first, then compare on insurance and format.
If you're searching for Charlie Health alternatives, something specific likely isn't working: it's not available in your state, it doesn't take Medicare, the 9-to-12-hour weekly commitment is too much, or you need a different level of care entirely.
The need for mental health support is real and growing. In its CDC Youth Risk Behavior Survey, the CDC found that about 2 in 5 U.S. high school students reported persistent feelings of sadness or hopelessness in 2023. While this is a risk indicator and not a formal diagnosis, it shows how many families are looking for help.
Charlie Health delivers strong virtual IOP care, but practical barriers send people elsewhere: limited state availability, no Medicare coverage, high time demands, or a mismatch in age range or intensity.
This guide evaluates six alternatives by weighing level of care first, then insurance acceptance, ages served, and format, so you can find the right fit faster.
Why do people look for a Charlie Health alternative?
Charlie Health is a virtual IOP, and it reports that about 8 in 10 clients who arrive with suicidal ideation are in remission by discharge. But several friction points send people searching for alternatives.
First, Charlie Health operates in only about 40 states, so many families find it isn't available where they live.
Second, it doesn't list Medicare, and it covers Medicaid only in states where IOP is a covered benefit.
Additionally, care is video only, so there's no in-person option for people who want to sit in a room with a provider.
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The 6 best Charlie Health alternatives
Here's how the six alternatives compare with Charlie Health at a glance across important factors, such as insurance acceptance, pricing, services, network size, and more.
1. Rula — Best for insurance-based therapy and psychiatry you can start quickly
Services offered: Therapy and psychiatry (individual, family, teen, child)
Insurance acceptance: Most major plans, Medicare in all 50 states, Medicaid in select states
Pricing: About $15 average copay with insurance
Rula brings insurance-covered therapy and psychiatry together in one coordinated platform, available in all 50 states, with visits that can start as soon as the next day. Unlike Charlie Health's virtual IOP model, Rula provides standard outpatient care — therapy and psychiatry you can access separately or together, including standalone psychiatry when you need medication management without ongoing therapy.
Before your first session, Rula verifies your insurance and gives you a cost estimate upfront. The platform shows you profiles that fit what you're looking for, and you can filter by gender, language, identity, specialty, availability, and treatment approach. If the fit isn't right, you can switch providers.
Rula patients pay an average of $15 per session with insurance across a network of 22,000 providers. Self-pay rates are about $150 for individual therapy and $165 for couples or family therapy when you are uninsured.
The outcomes are strong: 91% of patients report feeling better about their symptoms, and 97% found the right provider fit.
If you're weighing Rula and Charlie Health directly, our guide shows them side by side so you can make an informed decision about your care.
2. Brightside — Best for moderate-to-severe depression, anxiety, and suicide-risk support with medication
Services offered: Therapy, psychiatry, and a Crisis Care / Suicide Prevention Program
Insurance acceptance: Major plans; some Medicare and Medicaid
Pricing: $25 average copay with insurance
Brightside uses a precision, measurement-based model focused specifically on depression and anxiety, which sets it apart from broader platforms that treat a wider range of conditions. If you're dealing with moderate-to-severe symptoms and want a structured approach that tracks your progress with validated clinical tools, Brightside's model is built for that. The platform also runs a dedicated Crisis Care program designed for people at elevated risk of suicide.
You start with a free clinical assessment, then get matched to therapy, medication, or both, all managed through an app with messaging and progress tracking between appointments. You can typically start care in about two days, with video visits and unlimited messaging, all delivered virtually.
With insurance, members typically pay a copay of about $25 per session, though your actual cost depends on your specific plan and coverage.
The trade-offs: Brightside is fully virtual with no in-person option, so if you prefer face-to-face sessions, you'll need a different platform. For someone whose depression or anxiety has escalated but who doesn't need a residential setting, that middle ground is Brightside's real strength.
3. Sandstone Care — Best for teens and young adults who need in-person, higher-intensity treatment
Services offered: IOP, PHP, residential, and detox for teens (13–18) and young adults (18–35)
Insurance acceptance: Most major commercial plans; no Medicare or Medicaid
Pricing: Not publicly disclosed
Sandstone Care runs a full higher-acuity program: IOP, partial hospitalization, residential, and detox, with in-person locations across Colorado, Virginia, and Maryland. That makes it the closest match to Charlie Health's intensity, and it's one of the few alternatives here that treats both mental health and substance use together.
You start by calling admissions to verify your insurance, then complete a clinical assessment that determines your level of care. That assessment places you in IOP, PHP, residential, or detox based on clinical need.
The trade-offs are significant: in-person care is only available in three states, it accepts no Medicare or Medicaid, and it doesn't publish pricing on its website. That means you won't know your out-of-pocket cost until after you call and verify your insurance.
Because cost isn't posted, ask for a written estimate and a financial plan up front. If your insurance doesn't cover the full cost, confirm what payment plans or financial assistance Sandstone offers before you commit to admission.
4. Talkspace — Best for teens who want flexible, messaging-based therapy
Services offered: Therapy (13+) and psychiatry (18+), messaging plus live sessions
Insurance acceptance: Many major plans and Medicare; no Medicaid
Pricing: $10-$15 average copay
Talkspace uses an asynchronous messaging model that lets you text your therapist any time, then layer in scheduled live video or audio sessions when you need them. That flexibility sets it apart from platforms built around weekly appointments only. The platform also runs a dedicated teen therapy track for ages 13 to 17, which means your teen gets matched to a provider trained specifically in adolescent care.
You can start in about 48 hours after signing up. Once matched, you choose messaging only, live sessions only, or a combination, all managed from your phone. Talkspace offers psychiatry for adults 18 and up, so you can add medication management if your symptoms need it, though that service isn't available for teens.
Talkspace accepts many major insurance plans and Medicare, which gives it broader coverage than some alternatives on this list. With insurance, members typically pay a copay of $10 to $15 per session, though your actual cost depends on your specific plan and coverage.
The trade-offs: Talkspace is fully virtual with no in-person option, and it doesn't accept Medicaid.
See how Talkspace stacks up against Rula in our complete breakdown.
5. Grow Therapy — Best for families using Medicaid to find an in-network provider
Services offered: Therapy and medication support (couples, family, child/adolescent)
Insurance acceptance: Most major plans including Medicare and Medicaid
Pricing: About $21 average copay with insurance
Grow Therapy stands out for its large network of over 26,000 providers and the flexibility to meet virtually or in person, depending on what works better for your schedule and preferences. Among the options here, it lists the broadest Medicaid and Managed Medicaid coverage, which makes it a solid choice if you're on a government plan and want in-network care.
Most people get their first appointment within about two days, and the platform uses a marketplace model that lets you browse profiles and choose your own provider based on specialty, availability, and approach. You can filter by insurance, needs, treatment style, and availability, including nights and weekends, and booking typically takes about 10 minutes.
With insurance, sessions average about $21, though costs can vary depending on your specific plan and the provider you choose.
One thing to keep in mind: because Grow Therapy operates as a marketplace, self-pay rates and plan acceptance can vary by individual provider, so it's worth confirming your specific copay and coverage before you book. The platform also has no in-house crisis service and refers people to 988.
6. Thriveworks — Best for family therapy and in-person visits
Services offered: individual, child/teen (0–17), couples, family therapy, and psychiatry. Insurance acceptance: 360+ plans and Medicare; no Medicaid. Pricing: $0–$55 copay.
Thriveworks is a national mental health provider that operates through a network of over 340 physical offices rather than an online marketplace. It has a large physical presence staffed by employed clinicians who offer both therapy and psychiatry services, with a particular focus on family and child or teen care.
You browse provider profiles or call to get matched, and most people start within a week. Evening and weekend slots are available in many markets, which makes it easier to fit appointments around work or school schedules. The network is smaller at about 2,600 clinicians compared to marketplace platforms, but the employed model means more predictable availability and coordination.
Thriveworks accepts 360+ commercial insurance plans plus Medicare, with copays typically ranging from $0 to $55 depending on your plan.
The trade-offs: it doesn't take Medicaid, there's no 24/7 crisis line, and self-pay pricing varies by state, so you'll need to confirm your out-of-pocket cost based on your location.
Choose Thriveworks when an in-person office is non-negotiable, you need Medicare or commercial insurance acceptance, and you want the structure of a clinic rather than a marketplace.
What level of care does each option provide?
Level of care describes how much treatment you get and how often. It runs from weekly outpatient therapy, to an intensive outpatient program (IOP), to a partial hospitalization program (PHP), up to residential or inpatient care.
Here's where each option falls:
Charlie Health: A virtual IOP, about 9 to 12 hours a week of group, individual, and family sessions.
Sandstone Care: The widest range, from IOP and PHP to residential and detox.
Brightside: Outpatient therapy and psychiatry, plus a Crisis Care program for people at elevated risk.
Rula: Standard outpatient therapy plus online psychiatry and medication in one platform.
Talkspace: Standard outpatient therapy and psychiatry.
Grow Therapy: Standard outpatient therapy and medication support.
Thriveworks: Standard outpatient therapy and psychiatry.
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Which options take Medicare and Medicaid?
Medicare mostly covers people 65 and older or with certain disabilities, and Medicaid covers people with lower incomes. These are the plans where coverage gaps hurt most, and Charlie Health doesn't list Medicare at all.
Here's how each option handles Medicare and Medicaid:
Rula: Medicare in all 50 states and Medicaid in select states.
Grow Therapy: Both Medicare and Medicaid.
Brightside: Some Medicare and some Medicaid plans.
Talkspace: Medicare, including Medicare Advantage, but no Medicaid.
Thriveworks: Medicare, but no Medicaid.
Sandstone Care: Neither Medicare nor Medicaid.
Charlie Health: Medicaid in states where IOP is covered, and no Medicare.
Because Medicaid is run by each state, according to Medicaid.gov, acceptance changes by state and by specific plan. A platform that's in-network for one person may be out-of-network for another, so be sure to verify your coverage before you book.
What ages can use each platform?
Charlie Health serves ages 8 to 64, but the rules for therapy and psychiatry differ from one platform to the next.
The short version: yours (or your child's) age, and whether you also need medication, decides which options are open to you.
Here's who each platform serves:
Charlie Health: Ages 8 to 64.
Sandstone Care: Teens 13 to 18 and young adults 18 to 35.
Brightside: Ages 13 and up.
Talkspace: Therapy from age 13, psychiatry from age 18.
Thriveworks: Children and teens ages 0 to 17, plus adults.
Grow Therapy: Minors enrolled by a parent, with ages not otherwise stated.
Rula: therapy from age 5 and psychiatry from age 13.
Who should choose which alternative?
If you need full IOP intensity or a step-down: Charlie Health and Sandstone Care are built for structured, multi-hour weekly treatment. Sandstone adds in-person and residential levels.
If you rely on Medicaid: Rula (select states) and Grow Therapy have the broadest Medicaid access, while Sandstone Care, Talkspace, and Thriveworks don't take it.
If you rely on Medicare: Rula (all 50 states), Grow Therapy, Talkspace, and Thriveworks all accept it, and Charlie Health does not.
If your teen prefers messaging: Talkspace offers a dedicated 13-to-17 track with any-time messaging plus live sessions.
If you want family therapy or in-person visits: Thriveworks and Rula both offer family care, and both have in-person options.
If substance use or higher acuity is the concern: Sandstone Care's continuum and Brightside's Crisis Care are the closest fits.
If IOP feels like too much: Rula provides standard outpatient therapy and psychiatry, all-ages care, and next-day scheduling for people who don't need that intensity.
Whichever you choose, verify your insurance and provider availability before booking, and estimate your session cost so there are no billing surprises.
Frequently asked questions about Charlie Health alternatives
Is Charlie Health only for teens?
No. Charlie Health serves ages 8 to 64, though its virtual IOP was originally built for young people. It still centers on higher-acuity needs, so adults wanting standard weekly therapy often look at outpatient options instead.
Does Charlie Health take Medicare or Medicaid?
Charlie Health accepts Medicaid in states where IOP is covered but doesn't list Medicare. If you rely on Medicare, options like Rula (all 50 states), Grow Therapy, Talkspace, or Thriveworks are worth checking.
What's the difference between a virtual IOP and regular online therapy?
A virtual IOP provides about nine or more hours of structured treatment a week across several days. Regular online therapy is usually one weekly session. Choose based on how much support you need right now.
Which Charlie Health alternative is most affordable with insurance?
With insurance, Rula patients pay about $15 per session on average and Grow Therapy about $21. Subscription platforms like Brightside and Talkspace bill monthly or weekly instead. Your actual cost depends on your plan, so verify it first.
Find care with Rula
Choosing a mental health platform comes down to getting the right care without fighting your insurance to do it. With Rula, you can confirm your coverage in minutes and match with a provider chosen for your concern and preferences. You'll also see an estimated session cost before you book. Appointments can start as soon as the next day, by video or in person.
Rula brings therapy and psychiatry together in one place with crisis care. When you're ready to take the next step, Rula can help you find care that fits.
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