BetterHelp subscription vs pay-as-you-go therapy

Deciding to start therapy is an important and deeply personal step. Once you've made that decision, it’s natural to wonder how to make it work practically, especially when it comes to costs, frequency, and how sessions are delivered.

Two of the most common models for accessing therapy today are subscription-based therapy, where you pay a recurring monthly fee, and pay-as-you-go therapy, where you pay per session as needed.

Both options can support meaningful change, but the best fit depends on your circumstances, preferences, and how you’d like therapy to work in your life. Currently, people who are okay with subscriptions usually consider BetterHelp, so we’ll look into this platform in this guide.

A word on therapy

While it’s easy to focus on pricing or platforms, one of the most important parts of the therapy process is finding a therapist who feels right for you.

Research consistently shows that the quality of the therapeutic relationship is one of the strongest predictors of positive outcomes. This means feeling safe, heard, and supported by someone with the right skills and approach, not just how often or where you meet.

So, when weighing up options, it’s worth asking not just what fits your budget, but whether you can find a therapist you connect with, who has experience with your particular concerns, and who can work with your preferences and goals.

BetterHelp subscription vs pay‑as‑you‑go: what’s the real score?

Both subscription and pay-as-you-go models can offer access to qualified professionals and mental health support, but how they work day to day is quite different. Here's how they compare across key features:

Understanding BetterHelp's subscription-based therapy

BetterHelp offers a monthly subscription that includes:

• One live session per week (video, phone, or live chat)

• Unlimited messaging with your therapist

• The ability to switch therapists at any time

• Access via mobile app or browser

What it costs

BetterHelp plans in Australia cost around AUD 90 and AUD 120 per week, which amounts to approximately $360–$480 per month.

It’s worth noting that BetterHelp doesn’t offer Medicare rebates, and sessions are generally conducted with therapists based outside Australia. While the monthly cost may appear more affordable than some local services, this only works well if you attend all included sessions. 

Strengths of BetterHelp

• Sessions are pre-scheduled, helping you stay consistent

• Unlimited messaging allows for ongoing support between sessions

• Easy to access from anywhere via app or desktop

• Allows therapist switching

Limitations

• Less flexibility to cancel or skip sessions without losing value

• No Medicare rebates or Australian regulatory oversight

• Some concerns around therapist qualifications, as therapists are not always based in Australia

• The model is best for those who can attend weekly sessions to make full use of the plan

Understanding pay-as-you-go therapy

Pay‑as‑you‑go therapy lets you book individual sessions with a therapist. This can be one at a time, or multiple sessions at a time but with no upfront payment.

Platforms like Talked offer this model with a range of therapists, including psychologists, counsellors, and social workers. It’s also the most common model in private practice across Australia. Here’s how it often looks like:

• No subscriptions, just book and pay for sessions when you need them

• You choose how often to attend and with whom

• Some therapists offer after-hours or weekend appointments

What it costs

Session fees vary widely based on qualifications, experience, and whether the therapist is a psychologist, social worker, or counsellor. Therapy costs generally range from AUD 90 to AUD 350+ per session.

If you have a Mental Health Treatment Plan, you may be eligible for a Medicare rebate of around AUD 145.25 per session for up to 10 sessions per calendar year with an eligible provider.

Strengths

• Full flexibility, you decide when and how often to book

• Usually offers easier access to Australian-registered therapists and Medicare rebates

• You’re not paying for sessions you don’t use

• Ideal if you want to trial therapy or explore different therapists

Limitations

• Requires more initiative to maintain consistency

• May cost more over time if attending sessions frequently

• Booking availability may vary between therapists

So, what suits you best?

Choosing between BetterHelp’s subscription and pay-as-you-go therapy isn’t about finding the “best” model but about finding what fits your current needs.

If you know you’ll benefit from regular, structured sessions and can commit to meeting weekly or fortnightly, a subscription model might suit your goals. This consistency can help build momentum and reduce the need to reschedule or rebook manually.

On the other hand, if your schedule changes often, you're not sure how frequently you’ll need support, or you’d prefer to work with someone local, pay‑as‑you‑go might be the better option.

It offers more freedom and can align better with the way many Australians access mental health support, monthly or as needed.

There’s no pressure to get it perfect from the start. Many people adjust how they access therapy over time. What matters is finding a rhythm that feels manageable and supportive for you.

Final thoughts

There’s no one right way to approach therapy. What works for one person might not work for another, and your needs may shift along the way. What matters is starting with a model that feels doable, emotionally, practically, and financially.

If you're unsure, it’s okay to begin with a single session or even a short consultation. See how it feels and go from there, and remember that you can always change your approach later.

Whether you’re booking weekly or checking in monthly, showing up for yourself in therapy is a meaningful step toward feeling more supported, resourced, and understood.