Rula vs BetterHelp: Insurance and Cost Compared

• Choose Rula if you want couples, family or child therapy, the lower published copay, or a clear cash price. Choose BetterHelp if you want messaging and phone alongside video, 20% off your first month, or access outside the US.
• Both now take insurance. Rula publishes an average copay of $15 a session, compared with BetterHelp’s $23. BetterHelp’s insurance route is limited to commercial plans. Rula also publishes coverage information for Medicare Advantage and managed Medicaid.
• Rula offers couples, family and child therapy from age 5, plus psychiatry from age 13. Its published cash rate is $150 a session, and you choose your therapist from a list.
• BetterHelp connects you with one therapist through messaging, live chat, phone or video. It offers 20% off the first month and operates in Canada, the UK and Australia.

The main difference is how you pay and how you use the service. Rula works more like a traditional insurance-based clinic: you book with licensed clinicians and pay per session. BetterHelp is still best known for its $70 to $100 weekly subscription, which includes one live session a week and unlimited messaging. As of September 2026, BetterHelp also offers a separate insurance route billed per session, along with psychiatry through a partner clinic. Check your plan with Rula or start BetterHelp’s matching quiz to see your own numbers.

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Rula vs BetterHelp side by side

The figures above were checked September 13, 2026, and come from the company listed.

Choose Rula if

Rula is the stronger fit when you need broader therapy options, want a published cash price, or prefer choosing from a list of therapists.

• You need couples, family or child therapy. Rula offers individual, couples and family therapy under one account. Therapy starts at age 5, and psychiatry at age 13. BetterHelp.com offers individual therapy for adults. Couples use its sister site Regain, teens use TeenCounseling, and BetterHelp says it does not provide family therapy.
• You want a lower published copay and a price upfront. Rula publishes an average copay of $15, compared with BetterHelp’s $23. Rula also has a public cost estimator you can use before signing up. BetterHelp gives you an estimate after its quiz.
• You have Medicare Advantage or managed Medicaid. Rula publishes coverage information for both. BetterHelp accepts certain commercial plans only and confirmed on September 11, 2026, that it does not accept Medicaid, Medicare or TRICARE.
• You may need a controlled substance. BetterHelp says its psychiatric providers do not prescribe controlled substances. Rula excludes ketamine and says certain stimulants are subject to state rules, so availability depends on where you live. Neither service guarantees a prescription.
• You need a cash-pay option. Rula publishes a $150 per-session rate. If BetterHelp does not take your plan, its fallback is the $70 to $100 weekly subscription.

See which Rula providers take your plan for an estimated per-session cost before booking.

Choose BetterHelp if

BetterHelp may fit better if you want ways to contact your therapist between live sessions, need service outside the US, or want the current discount.

• You want more than a scheduled video call. You can reach the same BetterHelp therapist through messaging, live chat, phone or video. Messages are asynchronous, so you do not need to schedule them. Rula offers scheduled live video sessions.
• You live outside the US. BetterHelp operates in Canada, the UK, Australia, France, Germany and the Netherlands. Rula is US-only.
• You want a discount now. BetterHelp offers 20% off the first month through our link. That is worth roughly $56 to $80 against a first four weeks priced at $280 to $400. Rula does not run a promotion.
• You want tools between sessions. The subscription includes worksheets, goal and habit tracking, journaling, more than 300 support groups and over 35 classes.

Start BetterHelp’s quiz, and the 20% discount applies automatically to the first month.

How insurance works with Rula and BetterHelp

Both services now accept insurance, but the programs work differently.

BetterHelp says it is in network with more than 125 plans nationwide, including Cigna, Aetna, Optum, UnitedHealthcare, Blue Cross Blue Shield, Anthem, CareFirst, Curative and Highmark. It publishes an average therapy copay of $23. This option is separate from the subscription. It is billed per session through a partner provider group called Uplift Behavioral Health and covers one live session a week.

BetterHelp accepts certain commercial plans only. It confirmed on September 11, 2026, that it does not accept Medicaid, Medicare or TRICARE. Your preferred therapist may not be in network with your plan. If a claim is denied, you are responsible for the full cost.

Rula publishes acceptance of Medicare Advantage, Medicare fee-for-service and managed Medicaid in select states, along with commercial carriers. Medicaid members can book therapy, but not psychiatry.

Both services verify benefits electronically and warn that the estimate is not guaranteed. Rula’s public estimator gives you a figure before you sign up.

Rula vs BetterHelp cost

Rula charges per session. BetterHelp charges $70 to $100 a week for its subscription, or per session when you use its insurance route.

At the companies’ published averages, four weekly Rula sessions come to about $60. Four weeks of BetterHelp’s subscription cost $280 to $400. Four BetterHelp sessions through insurance come to about $92.

The BetterHelp subscription includes more than the live sessions. It also covers unlimited messaging, support groups and classes. That extra access may matter if you expect to message your therapist regularly.

BetterHelp’s four-week billing cycle begins on the day you are matched. Unused sessions do not roll over. They expire at the end of that billing cycle.

Rula charges no separate platform fee, so you pay your insurance cost share. Its published missed-appointment fees are $99 for therapy and $150 for psychiatry. The fee applies to a no-show or a cancellation made within 24 hours of the appointment. BetterHelp also charges for late cancellations or missed sessions, and its terms say a late fee can apply on the insurance route.

Both accept HSA and FSA cards. BetterHelp offers financial aid based on income and employment, but it does not publish amounts or eligibility thresholds.

Psychiatry and medication

BetterHelp offers psychiatry through UpLift for adults 18 and up. No referral is required, and care is provided by licensed nurse practitioners and physicians. Its published formulary includes sertraline, duloxetine, paroxetine, fluoxetine, bupropion, lamotrigine, citalopram, buspirone, propranolol, venlafaxine, trazodone and lurasidone. BetterHelp reports an average of 2.6 days to a first psychiatric appointment, based on its own platform data.

BetterHelp says its psychiatric providers do not prescribe controlled substances. They can evaluate ADHD, but they do not prescribe stimulants.

Rula offers psychiatry nationwide from age 13. Its policy excludes ketamine and says certain stimulants are subject to additional state regulation, so availability varies by state. Neither service guarantees a prescription. Both require an evaluation first.

This article is for information only and is not medical advice. Talk to a doctor or licensed clinician before starting, stopping, or changing any treatment.

Reviews, complaints and privacy

The review picture changes depending on the site. Rula has the higher Trustpilot score, 4.5 compared with BetterHelp’s 3.8, and a lower share of one-star reviews. BetterHelp has the higher BBB customer-review score, 4.0 from 322 reviews compared with Rula’s 2.79 from 154. Both have A+ accredited BBB ratings.

BetterHelp has 338 complaints over three years, compared with Rula’s 179. The raw totals are hard to compare per user because BetterHelp puts its user base in the millions, while Rula publishes no comparable figure.

Rula complaints often describe per-session estimates that rise after an insurance claim is processed, leaving the client with a bill weeks later. BetterHelp complaints tend to focus on subscription billing that continued.

BetterHelp settled with the Federal Trade Commission in March 2023 over allegations that it shared user email addresses, IP addresses and health questionnaire answers with advertising platforms. It paid $7.8 million in partial refunds and is now barred from sharing health data for advertising.¹⁵ No equivalent regulatory action against Rula was found.

If neither fits

If you have Medicaid, Grow Therapy works with Medicaid in participating states and handles billing and claims. Rula accepts managed Medicaid in select states, but Medicaid members can book therapy only, not psychiatry.

For insurance-covered psychiatry rather than therapy, Talkiatry is built around that type of care. Talkiatry is in network with major commercial plans and verifies your network status before the first visit.

For a closer look at each service, read our Rula Health review and BetterHelp review.