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Sesame is a cash-pay marketplace where you see a fixed price before you book, and visits are listed from $34. Good fit if you are uninsured or carrying a high deductible. Published hands-on tests split sharply on service quality, and billing is the soft spot, so book one visit before you subscribe to anything.
We did not use Sesame ourselves, so nothing here is written as first-hand experience. This estimate was compiled in October 2026 from nine sources: the merchant's own homepage, membership, weight-loss, Everyday Rx, referral, employer and Costco pages; its terms of service; 4,529 verified-buyer ratings on Trustpilot; the Better Business Bureau file for Sesame, Inc.; and published reviews from Innerbody, ChoosingTherapy, HelpGuide and Medical News Today, three of which ran their own hands-on bookings. Where the sources disagree, we say so rather than average the tension away.
What Sesame actually is
Sesame is a direct-pay healthcare marketplace run by Sesame, Inc., which also trades as SesameCare. It does not employ your clinician and it does not bill your insurer. Instead it lists individual doctors, nurse practitioners, physician assistants, therapists and dentists with a fixed cash price attached to each service, and you pay that price upfront.
The company's own homepage claims more than 10,000 board-certified providers, over a million patients and more than $50 million saved by those patients. Innerbody, which spent 60-plus hours on the platform, reports it is available in all 50 states, though which clinicians you can actually reach depends on your state and the time of day.
The catalogue is wider than most self-pay telehealth brands. Beyond online urgent care and prescription refills it covers mental health medication and therapy, a weight-loss programme marketed as Success by Sesame, menopause and PCOS care, fertility guidance, birth control, UTI and yeast-infection visits, erectile dysfunction, prescription skincare, dermatology, paediatrics, dentistry, and referrals for labs, MRI, CT and X-ray. Named medications on the booking pages run from Wegovy, Zepbound, Ozempic, Mounjaro and Rybelsus through to sertraline, escitalopram, sildenafil, metformin and prednisone.
Two layers sit on top of the marketplace. Sesame Plus is a $10.99-a-month or $99-a-year membership that takes money off each visit, and Everyday Rx is a separate subscription that prices more than 350 generic medications at $1 each with free home delivery.
What a visit really costs
These are the starting prices Sesame lists itself, read in early October 2026. Each clinician sets their own rate, so the figure you see in your own postcode can be higher.
| Service | Listed from | Sesame Plus example |
|---|---|---|
| Online urgent care visit | $35 a visit | $10 off |
| Video prescription refill | $39 a visit | $47 down to $37 |
| Dermatology video visit | $39 a visit | $10 off |
| Standard lab panel and consult | $42 | One free lab a year, $65 value |
| Paediatric same-day visit | $45 a visit | $10 off |
| Dentist appointment | $50 a visit | Cleaning and exam $145 down to $135 |
| Online therapy session | $79 a visit | Video session $75 down to $65 |
| Mental Health Rx subscription | $79 a month | Not applicable |
| Weight-loss programme | $59 a month on the annual plan, $99 month to month | Not applicable |
| Everyday Rx | $29 a month on the annual plan, $59 month to month | Not applicable |
Two of those lines deserve a second look. The weight-loss programme's headline $59 is the annual rate, and Sesame's own plan comparison puts the saving at $480 a year against paying monthly; the medication itself is billed separately, with the Wegovy pill advertised from $149 a month. Everyday Rx works the same way, $29 only on the annual commitment and $59 if you pay month to month.
Medical News Today, reviewing the wider catalogue, puts the realistic spread at $44 to $180 for an individual visit. The specialist end goes further than that. The ChoosingTherapy writer who booked a first psychiatry consultation in their own area paid $352, and found therapists in their state listed between $100 and $400-plus a session. The $34 headline is real, and so is the gap between it and a specialist booking.
Is Sesame Plus worth $99 a year?
The membership does one simple thing: it takes $10 off telehealth and primary care visits, $10 off in-person dental and specialist appointments, and includes one free lab or blood test a year that the merchant values at $65. The brand's own worked examples are a prescription refill dropping from $47 to $37, a video therapy session from $75 to $65, and a dental cleaning and exam from $145 to $135.
The maths is easy enough to do on the back of an envelope. At $99 a year, the free annual lab covers two thirds of the fee before you book anything, and three or four discounted visits clear the rest. The monthly option costs $131.88 over twelve months, so the annual plan is the cheaper of the two by a clear margin.
The membership cannot be combined with insurance or Medicare, and the free annual lab is not offered in Washington State. If you book once or twice a year, the pay-as-you-go price is the better deal.
Two discount routes bypass the membership entirely. Verified Costco members get $29 virtual primary care, $79 virtual therapy, a $72 health check-up, $65-a-month mental health medication, $49-a-month PCOS and menopause care, $45-a-month prescription skincare, and an extra 10% off specialty visits. Separately, Sesame @ Work gives employees and their families $10 off with visits as low as $37, plus up to 20% off once an employer verification code is entered. Check both before you pay for Plus.
Where the sources agree
Six published verdicts, and they do not line up neatly. The agreement is on the mechanics, not the experience.
| Source | Score or verdict | Based on |
|---|---|---|
| Trustpilot | 4.6 / 5 from 4,529 ratings | Verified-buyer reviews, Oct 2026 |
| HelpGuide | 88% of surveyed users satisfied, 77% would recommend | One month hands-on, two therapists |
| Medical News Today | Favourable for uninsured patients | Editorial review, no testing claimed |
| ChoosingTherapy | 3.5 / 5 | Hands-on psychiatry booking, paid $352 |
| Better Business Bureau | B− letter rating | 17 complaints closed in three years |
| Innerbody | 4.5 / 10 editor's rating | 60-plus hours hands-on plus support contact |
Every one of them confirms the same three things. Prices are visible before you commit, there is no claims process or deductible arithmetic to do, and same-day or next-day slots are genuinely available. Every one of them also confirms that Sesame will not bill insurance, although it issues itemised bills and superbills so you can seek reimbursement yourself, and accepts HSA and FSA cards.
Where the sources clash
The spread between a 4.6 out of 5 and a 4.5 out of 10 is the most interesting thing about this brand, and it is not noise.
Trustpilot's 4,529 ratings are dominated by people who booked one visit, got seen quickly and left happy: 85% of them are five-star. Innerbody's much harsher editor's rating comes from sustained use and a deliberate customer-support test, and its criticisms are structural rather than clinical, covering generic-only prescribing, patchy in-person availability that can stretch to a week, and costs that mount if you lean on the platform regularly.
Read together, the two are not contradictory. They are measuring different things. A single transactional visit is where Sesame is strongest; anything that requires the company to keep track of you over time is where published testing turns sceptical.
The Better Business Bureau position is also contested. Medical News Today cites an A rating for the company, while the BBB file we read in October 2026 shows a B− letter grade with 17 complaints closed in the previous three years. If a BBB grade matters to your decision, check the live file rather than trusting any review's snapshot of it, including ours.
What patients praise and complain about
Strengths
- Verified buyers on Trustpilot repeatedly describe clinicians as attentive and professional, and the booking-to-prescription flow as fast.
- Both hands-on testers who booked mental health appointments got a slot inside two days, one of them running a 35-minute psychiatry session over an iPhone.
- Published reviews single out the filters as unusually practical, letting you sort providers by price, gender, language, availability and rating before you pay.
- Innerbody confirms SesameRx generics at $1 to $11 for a 30-day supply, which undercuts most retail pharmacy counters.
- HelpGuide's testers rated between-session direct messaging with providers as responsive.
Weaknesses
- Billing is the single most repeated complaint. Customers on Trustpilot report duplicate charges for one consultation and charges landing after a cancellation.
- Multiple BBB complainants describe paying for lab work a provider never submitted, and being refused refunds for membership months they never used.
- Support is slow for a minority. In HelpGuide's user survey, 24% waited more than three days for a reply.
- Quality varies by individual clinician rather than by brand standard, including one Trustpilot account of a provider ending the call and another of a recommended provider lacking the credentials for the requested treatment.
- Controlled substances are not prescribed at all, and both ChoosingTherapy and the merchant's own mental health page state this plainly.
- HelpGuide notes there is no therapist-matching questionnaire, so finding the right clinician is manual browsing, and 9% of its surveyed users never found a suitable one.
Before you book: the refund window
Sesame's refund terms are stricter than a typical online purchase, and they explain a good share of the billing complaints above. These come straight from the terms of service.
- A virtual visit can be cancelled up to three hours before the slot for a refund.
- An in-person visit needs 24 hours' notice.
- Labs, imaging and unscheduled appointments can be cancelled up to 10 days after the purchase date.
- No refunds are issued for no-shows, for not receiving a prescription, for disagreeing with the clinical outcome, or for any request made more than 10 days after purchase.
- Sesame Plus must be cancelled at least 48 hours before the renewal date, and part-used terms are not refunded pro rata.
The two clauses that catch people out are the clinical-outcome exclusion and the 10-day cut-off. Paying for a visit does not buy a prescription, and a charge you spot on a statement five weeks later is outside the window. Set a calendar reminder 48 hours before any Sesame Plus renewal you do not intend to keep.
Support runs through [email protected], a ticket inside your account, or +1 (877) 947-6411. Based on the complaint pattern, raise a billing issue in writing and raise it early.
Who Sesame suits
- Uninsured adults who need a real clinician for a defined, short problem: a UTI, a sinus infection, a rash, a refill, a doctor's note.
- Anyone on a high-deductible plan where a $35 to $50 cash visit is cheaper than the paperwork and the deductible hit.
- HSA and FSA holders, since both are accepted.
- Costco members and employees of a participating company, who get materially better prices than the public list.
- People on stable generic medication who want $1 refills delivered rather than a pharmacy queue.
Who should look elsewhere
- Anyone with strong employer insurance and a low copay, where Medical News Today's own conclusion is that the value sits elsewhere.
- Patients who need a controlled substance, which Sesame does not prescribe.
- Patients who need continuous, co-ordinated long-term care; published reviews consistently frame this as a short-term, per-episode service.
- Anyone who wants to be matched to a therapist rather than browse and choose one themselves.
- Anyone needing in-person specialty care in a thin market, where availability can run to a week.
Better picks for some needs
Amazon One Medical pay-per-visit is the closest price competitor for simple complaints, at $29 for a messaging visit and $49 for a video visit across more than 30 common conditions, with no membership or insurance required. It is narrower than Sesame and has no dental, no in-person specialists and no marketplace of individual clinicians, so prefer it when your problem is on its list and you want the lowest price.
Teladoc charges $89 for a General Medical visit without insurance, which is more than double Sesame's entry price. Its advantage is coverage: it is the default telehealth benefit inside a great many US insurance plans, so check whether you already have it before paying cash anywhere.
A subscription therapy platform such as BetterHelp is the alternative HelpGuide points to for mental health specifically, on the strength of matching and built-in resources rather than price. Prefer Sesame if you want to choose your own clinician and see the session price first.
Sesame Care FAQ
Is Sesame Care legit?
Yes. It is operated by Sesame, Inc., trading as SesameCare, and holds a 4.6 out of 5 rating from 4,529 verified-buyer ratings on Trustpilot alongside a B− letter grade with the Better Business Bureau. Clinicians are board-certified, and three published reviews booked and completed real appointments through it. The recurring complaints are about billing and support, not about whether the care is real.
Does Sesame Care take insurance?
No. Sesame does not bill insurers or Medicare at all. It issues itemised bills and superbills so you can claim reimbursement from your own insurer, and it accepts HSA and FSA cards.
How much is a Sesame Care visit?
Online urgent care is listed from $35 a visit, dermatology and video refills from $39, paediatrics from $45, dentistry from $50 and therapy from $79. Medical News Today puts the realistic range at $44 to $180 for a single visit, and specialist consultations go higher: one tester paid $352 for a first psychiatry appointment.
Is Sesame Plus worth it?
It pays for itself at roughly three or four visits a year, or sooner if you use the free annual lab the merchant values at $65. The annual plan at $99 beats the $10.99 monthly option, which totals $131.88 over a year. If you book once a year, skip it.
Can Sesame Care prescribe controlled substances?
No. Controlled substances are excluded, which rules out stimulants for ADHD and most benzodiazepines. The platform also prescribes generics rather than brand medication through its own pharmacy.
Can you get a refund from Sesame Care?
Only inside the stated windows: three hours before a virtual visit, 24 hours before an in-person one, or up to 10 days after purchase for labs and imaging. Nothing is refunded for a no-show, for not receiving a prescription, for disagreeing with the clinical outcome, or for any request made after the 10-day mark.
Bottom line
Sesame does the hard part of American healthcare well: it tells you the price before you commit, and it gets you in front of a real clinician the same day for the cost of a takeaway meal. Our confidence in that half is high, because the merchant's pricing pages, 4,529 verified-buyer ratings and three independent hands-on bookings all point the same way.
Our confidence in the administrative half is low, and deliberately so. Billing disputes, membership refunds and support response times are where every critical source converges, and the 11% one-star share on Trustpilot says the failures are concentrated rather than rare. Treat it as a per-visit service, book one appointment before you commit to any subscription, and keep an eye on the renewal dates.
If you are booking a first visit, the brand currently runs a 20% discount on it for new accounts, and the live offers are listed above the booking flow.