BetterHelp vs. Medicaid Therapy: What's Actually Free for NC, GA, and VA Residents

You've probably seen the BetterHelp ads. On YouTube before the video you actually wanted to watch. In a podcast mid-sentence. From a creator you follow. The pitch sounds simple: download an app, answer a few questions, get a therapist. Easy.

And if you're on Medicaid, you might have wondered, does BetterHelp take Medicaid? Can I use my coverage there? The short answer is no. BetterHelp does not accept Medicaid, Medicare, or any insurance at all. It's a subscription service, and you pay out of pocket every month, usually between $240 and $360. That's real money. For a lot of people on Medicaid, that's the phone bill, or groceries for two weeks.

Here's what most of those ads don't mention: if you're a Medicaid member in North Carolina, Georgia, or Virginia, you may already have online therapy covered. Fully. This article breaks down what BetterHelp actually costs, why it doesn't work with Medicaid, and what your real options look like.

Does BetterHelp Take Medicaid? Here's the Real Answer

No. BetterHelp does not accept Medicaid, and they've been pretty upfront about this on their own site. They don't work with any insurance, period. The entire platform is built as a direct-to-consumer subscription. You pay, you get access. Simple for them, expensive for you.

As of 2025, BetterHelp costs between $60 and $100 per week, billed monthly. That's $240 to $400 a month depending on your plan and location. They do offer financial aid for some users, but it's not guaranteed, the discount isn't always significant, and you still won't pay $0.

There's also a few other things worth knowing about BetterHelp. In 2023, the FTC fined them $7.8 million for sharing users' private health data with Facebook and Snapchat for advertising purposes. That's not a rumor, it's a matter of public record. If privacy matters to you (and it should when you're talking about mental health), that's worth factoring in.

None of this means BetterHelp is worthless. For someone with a stable income and no insurance, it fills a real gap. But for Medicaid members? There are better options that cost a fraction of the price, or nothing at all.

What Free Therapy on Medicaid Actually Looks Like

"Free therapy" sounds like a catch. Like there has to be a waitlist, or a limit, or some asterisk buried in the fine print. Sometimes there is. But Medicaid mental health coverage is more robust than most people realize, especially in the three states Lavni serves.

Here's how it generally works. Medicaid is a federal-state insurance program. Mental health services, including individual therapy with a licensed therapist, are a covered benefit. When you see a Medicaid-credentialed provider, your insurance pays them directly. Your copay, if you have one at all, is usually $0 to $3 per session.

That's per session. Not per month. Each appointment.

And since 2020, telehealth rules have expanded significantly. In most Medicaid plans, online therapy sessions are covered the same way in-person ones are. You don't have to drive anywhere. You don't need a car. You just need a phone or a computer and a private-ish space.

The catch, and yes, there is one, is finding a therapist who actually accepts your specific Medicaid plan. That's where things get complicated. Not every therapist is credentialed with Medicaid. Some have long waitlists. Some only see adults, or only see kids, or only do certain types of therapy. Finding a Medicaid therapist who has availability takes more effort than downloading an app, but the payoff is real.

State-by-State: What Medicaid Covers for Online Therapy in NC, GA, and VA

Medicaid isn't one program, it's 50 slightly different programs. The rules in North Carolina aren't identical to the rules in Georgia or Virginia. Here's what matters for each state.

North Carolina

NC Medicaid Direct covers individual therapy, group therapy, and psychiatric services. Telehealth is covered. In 2023, North Carolina expanded Medicaid under the ACA, which added roughly 600,000 more residents to the rolls. If you weren't eligible before, you might be now. NC Medicaid plans include Carolina Complete Health, Healthy Blue, UnitedHealthcare Community Plan, WellCare, and Aetna Better Health. Lavni works with most of these. You can also find a Medicaid therapist in Raleigh, Charlotte, Durham, Greensboro, and Fayetteville.

Georgia

Georgia has not fully expanded Medicaid, so eligibility is more restricted than in NC or VA. But if you do qualify, Georgia Medicaid (through plans like Amerigroup, Peach State Health Management, and WellCare) covers mental health services including telehealth. Georgia Pathways, the state's partial expansion program, has added some coverage for working adults. If you're in Atlanta or nearby, Medicaid therapists in Atlanta are available through Lavni.

Virginia

Virginia expanded Medicaid in 2019, and coverage is solid. Medicaid Managed Care plans in Virginia include Anthem HealthKeepers Plus, Molina Healthcare, Optima Health, and Virginia Premier. Telehealth therapy is covered. If you're in Richmond or Northern Virginia, find a Medicaid therapist in Richmond through Lavni.

Why People Search for BetterHelp When Medicaid Therapy Exists

This is a fair question. BetterHelp spends a lot on advertising. Medicaid therapy programs spend almost nothing on marketing. So of course more people have heard of one than the other.

There's also a perception issue. A lot of people assume Medicaid mental health coverage means long waits, limited choices, or lower quality care. Sometimes that's true. But it's not always true, and it's changing, especially with platforms built specifically around Medicaid access.

People also search for BetterHelp because it feels simple. No insurance cards. No prior authorizations. No explaining your plan name to a receptionist. You pay, you get matched, you start. That ease is genuinely appealing. But "easy to start" and "affordable" aren't the same thing.

At Lavni, we've helped over 5,000 clients access therapy through Medicaid. The onboarding isn't quite as slick as a consumer app, but most people are booked within 1-2 days of signing up. And instead of $300 a month, they're paying $0 to $3 per session. That math matters.

If you've been putting off therapy because you thought you couldn't afford it, or because you assumed your Medicaid wouldn't cover it, it's worth taking another look. Our guide on getting started with therapy on a budget walks through the whole process.

What to Look for in a BetterHelp Alternative That Takes Medicaid

Not all Medicaid therapy platforms are the same. Here's what actually matters when you're choosing one.

Do they actually accept your specific plan? Medicaid has a lot of managed care organizations. A platform might say they accept "Medicaid" but only work with one or two plans in your state. Ask specifically about your plan name.

How long is the wait? Some Medicaid providers have 6-8 week waitlists. That's a long time when you're struggling. Ask upfront.

Can you choose your therapist? Being matched by an algorithm is fine, but you should also be able to switch if it's not working. Therapeutic fit matters, a lot. There's a reason knowing whether therapy is working starts with having the right person.

Are the therapists licensed? This sounds obvious, but some platforms use coaches or counselors who aren't licensed mental health professionals. For Medicaid billing, therapists have to be licensed, so this is actually a built-in protection when you use a Medicaid-credentialed provider.

Do they handle the insurance billing? You shouldn't have to submit claims yourself. A good platform handles all of that on the backend. You show up, you do the work, they handle the paperwork.

Lavni was built specifically to make Medicaid therapy work the way it should. 185+ clinicians. Telehealth sessions you can do from home. Billing handled for you. And a team you can actually call if something goes wrong: (980) 890-7995.

If you want more detail on how Medicaid online therapy actually works before you sign up, our post on how online therapy works with Medicaid covers the whole process from first session to billing.