Please note: This review reflects information we gathered on the date it was researched and may now be out of date. Providers frequently change their pricing, plans, medications, and policies. Any ratings, reviews, and customer feedback are gathered from publicly available online sources and may have since changed or no longer be accurate. Always do your own research and confirm the latest details directly with the provider before making any decision.
Octave Review: Insurance-First Therapy, And We Get $300
Octave provides individual, couples and family therapy through a network of licensed therapists, built around insurance rather than cash pay — their site says clients average $28 a session with insurance, against a self-pay market of $100 to $250. That is a genuinely good model. We are also paid $300 every time somebody signs up through this page, which is the largest bounty on this site, and on a mental health service that deserves to be said before anything else.
If you need help now, do not wait for an appointment
In the United States, call or text 988 to reach the Suicide and Crisis Lifeline. It is free, available 24 hours a day, and it is the right first step if you are having thoughts of harming yourself or are in acute distress. If someone is in immediate danger, call 911 or go to an emergency department. Booking a therapy appointment — through Octave or anyone else — is a plan for next week, not for tonight, and nothing on this page should delay you from calling 988.
We are paid $300 for this one. Here is what pays us nothing.
Three hundred dollars per signup is more than seven times our next-largest commission and more than a thousand times the smallest. On any offer that pays that much, the honest thing to do is put the alternatives first. Your insurer's own in-network provider directory lets you find and book a therapist with no intermediary. If you are employed, an Employee Assistance Programme often provides several free sessions. Community mental health centres, university training clinics and sliding-scale private therapists all cost less than a full private rate. And 988 is free. Read what follows knowing what we stand to make from it.
Our Verdict
Octave · findoctave.com · insurance-first therapy, 22 states
Built around insurance, which is the whole ballgame on cost
Their site states clients pay an average of $28 per session through insurance, and describes the US self-pay market in 2025 as $100 to $250 — $150 to $250 in the most expensive states including New York, California and North Dakota, and $120 to $130 in the cheapest. Being in-network is the single largest lever on what American therapy costs, and a great many therapy startups avoid the difficulty by being cash-pay only. Doing the harder thing deserves credit.
“$28 average” assumes your deductible is behind you
That figure is an average of what insured clients pay, which in practice means a copay. If you are on a high-deductible plan and have not met the deductible, you pay the full negotiated in-network rate until you have — which is a great deal more than $28 and could be most of a year's sessions. To their credit they publish a free cost estimation tool, so use it and get your own number before you book rather than budgeting on an average.
Unavailable in 28 states on this offer
More than half the country is excluded: Alabama, Alaska, Arkansas, Delaware, Hawaii, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Michigan, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Dakota, Oklahoma, Rhode Island, South Dakota, Utah, Vermont, West Virginia and Wyoming. The named priority states are California, New York, New Jersey, Pennsylvania, Illinois, Florida and Texas. Check your state first.
Why this is relevant on a GLP-1
Not because these drugs cause psychiatric illness — regulators looked and did not find that. Because if eating was how you handled stress, removing appetite pharmacologically removes the mechanism without addressing what it was doing; because body image frequently does not improve on arrival at a target weight; and because a history of disordered eating interacts badly with appetite suppression. Those are specific reasons, and they are better reasons than the ones usually given.
They publish the market context, including what competitors charge
Their own therapy page explains what therapy costs across the US, names the most and least expensive states with figures, and lists the factors that move the price. A company explaining the market it operates in — rather than only its own pricing — is giving you the information needed to judge whether it is good value, which is unusual and useful. robots.txt also explicitly permits crawling with no restrictions on AI agents.
Our Top Recommended Provider: CoreAge Rx
After reviewing dozens of GLP-1 telehealth providers, CoreAge Rx is the one we recommend most. CoreAge Rx is one of our partners — read on for why we recommend them:
Flat-Rate Pricing
Same cost at every dose level — no price jumps as you titrate up.
Verified Pharmacies
US-licensed physicians and NABP-verified 503A compounding pharmacies you can trust.
Everything Included
Medication, supplies, free shipping, and ongoing clinical support — no hidden fees.
Active Community of Members
Ask questions, share progress, and get answers from other patients on the same journey — alongside ongoing clinical support from your care team.
988
Free US crisis line — call or text now
$28
Their stated average per session with insurance
28
States excluded from this offer
$300
What we are paid if you sign up
Mental health on a GLP-1: what the evidence says, carefully
Start with the question people actually have, and answer it precisely rather than reassuringly. Case reports of suicidal thoughts in people taking GLP-1 receptor agonists prompted formal safety reviews by regulators on both sides of the Atlantic. In January 2024 the FDA stated that its preliminary evaluation had not found evidence that these medicines cause suicidal thoughts or actions, while saying its investigation continued. The European Medicines Agency's safety committee reached a similar conclusion, finding that the available evidence did not support a causal association. That is the current position: reviewed, and no causal link established.
And yet the labelling for semaglutide in weight management advises monitoring patients for depression, suicidal thoughts or behaviour, and discontinuing if they emerge. Those two facts are not in conflict. Regulators concluded the drug has not been shown to cause the problem; the label still instructs clinicians to watch for it, as is standard for medicines used in weight management. What that means for you is simple and practical: tell your prescriber about any history of depression, anxiety, self-harm or eating disorder before you start rather than afterwards, and if your mood worsens on treatment, treat that as a reason to contact them rather than something to push through.
Now the reasons for therapy that have nothing to do with drug side effects, and which we think are the stronger ones. If eating was how you managed stress, boredom, grief or anxiety — and for a great many people it was — then a medication that removes appetite has removed the mechanism without touching what the mechanism was for. That does not make the underlying thing disappear. It makes it look for somewhere else to go, and people are frequently surprised by what surfaces once food is no longer available as an option. Working out what eating was doing for you is a therapy question, not a pharmacology one.
Then body image, which is the most reliably disappointing part of the whole process. There is a widespread assumption that dissatisfaction with your body is caused by the body, and will therefore resolve when the body changes. Very often it does not. People reach a weight they spent years wanting and find the mirror has not delivered what they expected — because loose skin arrived instead of the outline they imagined, or because the dissatisfaction was never really about the number. That experience is common, it is not a failure of will, and it responds much better to a conversation than to another purchase. We have reviewed a great many products on this site sold to people trying to fix that feeling with money.
Two more, briefly. A history of an eating disorder deserves a specific conversation with a clinician before starting a GLP-1, because appetite suppression and disordered eating patterns interact in ways that are hard to see from inside — and because binge eating disorder, for which these drugs are sometimes considered, is a psychiatric condition that needs psychological treatment alongside rather than instead. And losing a fifth of your body weight changes how strangers, colleagues and family treat you, often markedly and sometimes uncomfortably. People expect to feel straightforwardly good about that and are unsettled when they do not. It is a reasonable thing to take to a therapist.
Ways to get therapy, cheapest first
| Route | Typical cost | We earn |
|---|---|---|
| 988 Suicide and Crisis Lifeline | Free, immediate | $0 |
| Employer Employee Assistance Programme | Often several sessions free | $0 |
| Your insurer’s own in-network directory | Your copay — same economics, no intermediary | $0 |
| Community clinics, training clinics, sliding scale | Reduced or income-based fees | $0 |
| Octave | Stated $28 average with insurance; full rate until deductible met | $300 |
| Cash-pay private therapy | $100–$250 per session per their own figures | $0 |
Octave figures from findoctave.com/individual-therapy, retrieved 12 August 2026. Other routes are described generally; availability, eligibility and cost vary by employer, insurer, state and provider. This table is information, not a recommendation about your care — and the right route depends on what you need, not only on price.
What we verified
1. Insurance-first is the substantive claim
The American therapy market has a structural problem: many good therapists do not take insurance, because reimbursement rates are low and the administration is punishing. The consequence is a two-tier system in which insured people struggle to find in-network providers with availability, and end up paying cash rates. A great many venture-backed therapy platforms have responded by leaning into cash pay and selling convenience instead — which is easier to operate and leaves the patient paying $150 a session indefinitely.
Octave's positioning is the opposite, and their own numbers show why it matters. They state that clients pay an average of $28 per session through insurance, and they describe the self-pay market they operate in as $100 to $250 nationally — naming New York, California and North Dakota among the most expensive at $150 to $250 an hour, and giving $120 to $130 for the cheapest states. Whatever you think of any single figure, the gap between a copay and a cash rate is the difference between therapy you can sustain for a year and therapy you stop after six weeks. Being in-network for a claimed 33 million Americans is the thing worth buying here.
They also publish that market context on their own site, which we want to note approvingly. A company that explains what therapy costs generally, names the expensive and cheap states, and lists the factors that move the price is handing you the means to judge whether it is good value — including the means to conclude it is not. Very little of what we have reviewed this year does that. There is also a free cost estimation tool, which is the correct answer to a pricing question that genuinely does depend on your plan.
2. The deductible, and what an average conceals
An average of $28 per session is a real number and a partial one. In US insurance, what you pay for an in-network visit depends on where you are in your plan year. If your plan applies a deductible to outpatient mental health, you pay the full negotiated in-network rate for every session until that deductible is satisfied, and only then drop to a copay or coinsurance. For someone on a high-deductible plan starting therapy in January, the first stretch of sessions can cost several times the advertised average — and the average is computed across everyone, most of whom are past that point.
None of that is Octave's doing; it is how American health insurance works. But it means the $28 figure should not be used for budgeting, and the right response is the tool they already provide: get an estimate for your specific plan and state before booking. Two further questions worth asking directly, because they determine what you actually pay: does my plan apply the deductible to outpatient mental health, and is this billed as in-network at my specific plan level rather than merely at my insurer.
The other significant limit is geography. This offer excludes 28 states — more than half the country — with California, New York, New Jersey, Pennsylvania, Illinois, Florida and Texas named as priorities. That is a large exclusion list and it is the first thing to check, because nothing else in this review matters if you live in one of them. We should also note plainly what we did not verify: their site returned 403 to ordinary requests and we read it in a browser, and we have not reviewed their therapist credentialing process, their cancellation or no-show policy, their privacy practices, or how they handle clients who need a level of care beyond weekly outpatient therapy.
3. On being paid $300 to write this
We have disclosed a commission on every page of this site, from one per cent on sporting goods to a flat forty dollars on injectables. Three hundred dollars for a single therapy signup is a different order of magnitude, and it is worth explaining why that matters rather than simply noting it. A bounty that large makes it rational for a publisher to write whatever converts, and mental health is a field where the person reading may be in a poor position to evaluate what they are being told.
So the structure of this review is deliberate. The crisis line comes before the product, because someone who needs 988 tonight should not read four hundred words of vendor analysis first. The alternatives that pay us nothing come before the praise, because they are genuinely better for some people — your insurer's own directory gets you the same in-network economics without an intermediary, and an employer assistance programme is free. The deductible caveat comes before the $28 headline. That ordering costs us conversions and it is the only defensible way to write this page.
Which is not an argument against Octave. On the evidence we could gather it looks like a serious operation doing the harder, better thing on payment, and if you are in an eligible state, have insurance, and want therapy, it is a reasonable place to look. It is an argument for reading any enthusiastic write-up of a mental health service — including this one — with the commission in view. If a page like this does not tell you what it earns, assume it earns something, and go and look at your insurer's directory as well before you decide.
In its favour
- Built around insurance rather than cash pay, which is the single largest lever on what therapy costs in the US.
- States an average of $28 per session for insured clients against a self-pay market they describe as $100 to $250.
- Publishes the wider market context — including what therapy costs elsewhere and in which states — rather than only its own pricing.
- Offers a free cost estimation tool, which is the right answer to a price that genuinely depends on your plan.
- Claims in-network reach for 33 million Americans, and a large vetted therapist network with individual, couples and family options.
- robots.txt explicitly permits crawling with no restrictions on AI agents.
Against it
- Excluded in 28 states on this offer — more than half the country.
- The $28 average assumes your deductible is met; before that you pay the full in-network rate.
- You can get the same in-network economics through your insurer's own directory without any intermediary.
- We could not verify therapist credentialing, cancellation policy, privacy practices or escalation pathways for higher-acuity need.
- Their site returned 403 to ordinary requests, so everything here was read in a browser session.
- The $300 bounty we are paid is a very large incentive on a service where readers may be poorly placed to evaluate advice.
Our verdict: 4.1 out of 5
A serious operation doing the harder thing on payment — check your state, check your deductible, and check your insurer's own directory before you take our word for it.
Octave is built around insurance in a market where a great many therapy companies avoid it, and that single decision is worth more to a patient than any feature. Their own figures make the case: an average of $28 a session for insured clients, against a self-pay market they describe as $100 to $250 nationally. That is the difference between therapy you can keep doing for a year and therapy you abandon in week six, and week six is roughly where most of the benefit has not happened yet.
They also do something we have seen almost nowhere else in this series: they publish the market they compete in. Their own page explains what therapy costs across the US, names the most and least expensive states with figures, and sets out what moves the price — which hands a reader the means to conclude that Octave is not good value for them. Alongside a free cost estimator, that is a company that appears willing to be measured. It earns real credit.
Two things to check before anything else. Your state, because this offer excludes twenty-eight of them and nothing else matters if you are in one. And your deductible, because the $28 average is a copay figure and if your plan applies a deductible to outpatient mental health you will pay the full negotiated rate until it is met — potentially for months. Use their estimator rather than the average, and ask directly whether your plan applies the deductible to mental health and whether you are in-network at your specific plan level rather than merely at your insurer.
For readers of this site, the case for therapy alongside a GLP-1 is stronger than the usual vague one and it does not depend on drug side effects. Regulators reviewed the reports of suicidal thoughts and did not find a causal link, while the labelling still tells clinicians to monitor for mood changes — so tell your prescriber your psychiatric history before you start, and treat worsening mood as a reason to call rather than something to endure. The better reasons are these: if eating was managing something, removing appetite does not remove the something; body image very often fails to improve on reaching a target weight; and a history of disordered eating interacts badly with appetite suppression. Those are questions a therapist can help with and a prescription cannot.
Four-point-one, with the caveat stated as loudly as we can. We are paid $300 if you sign up here, which is more than seven times our next-largest commission, on a service where the reader may be in a difficult moment. So: if you are in crisis, call or text 988 now, not later. If you are employed, check for an Employee Assistance Programme, which is often free. And whatever you decide, open your insurer's own in-network directory alongside this page, because it gets you the same economics without anybody being paid a bounty for the introduction. If Octave still looks like the right option after that, it probably is.
Frequently asked questions
What is Octave?
A direct-to-consumer therapy provider offering individual, couples and family therapy through a network of licensed therapists, with insurance as the primary payment route. Their site describes thousands of continuously-vetted therapists and says they are in-network for 33 million Americans. The presenting issues they name are anxiety, depression, stress and burnout. It is a therapy service, not a GLP-1 prescriber, and it has no connection to any medication.
How much do you earn if I sign up?
Three hundred dollars, flat, per conversion. That is by a wide margin the largest commission of any offer we have reviewed on this site, and it is being paid for sending someone into mental health treatment. You should hold that in mind for the whole of this review. It is why the next answer is a list of ways to get help that pay us nothing, and why we have put the deductible caveat before the praise.
What are the options that don't pay us anything?
Several, and some are better for some people. If you are in crisis in the US, call or text 988 — the Suicide and Crisis Lifeline — which is free and available now. If you have insurance, you can search your insurer's own in-network provider directory directly and book a therapist without any intermediary. If you are employed, check whether you have an Employee Assistance Programme, which typically offers a number of free sessions. Community mental health centres, university training clinics and therapists offering sliding-scale fees all exist and are all cheaper than a full-rate private session.
What does Octave actually cost?
It depends on your insurance, and the headline number needs a caveat. Their site states clients pay an average of $28 per session when paying through insurance, against a self-pay market they describe as $100 to $250 nationally in 2025 — $150 to $250 in the most expensive states including New York, California and North Dakota, and $120 to $130 in the cheapest. The $28 is an average of what insured clients pay, which is a copay figure. If you have a high-deductible plan and have not met your deductible, you will pay the full negotiated rate until you do, which is a very different number.
Is the in-network model genuinely better?
For cost, yes, and it is the single most important thing about them. Being in-network is the largest lever on what American therapy costs — the gap between an in-network copay and a full self-pay rate is routinely five to ten times. A great many therapy startups are cash-pay only and market convenience instead, which quietly means paying $150 a session indefinitely. Building around insurance is the harder and more useful thing to do, and they also publish a free cost estimation tool so you can get a figure before booking rather than after.
Where is it not available?
In more than half the country, on this offer. The listing excludes 28 states: Alabama, Alaska, Arkansas, Delaware, Hawaii, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Michigan, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Dakota, Oklahoma, Rhode Island, South Dakota, Utah, Vermont, West Virginia and Wyoming. The priority states named are California, New York, New Jersey, Pennsylvania, Illinois, Florida and Texas. Check your own state before spending time on it.
Why would someone on a GLP-1 want therapy?
Several reasons that are specific rather than general. If eating was how you managed stress, a drug that removes appetite removes the coping mechanism without addressing what it was for, and that gap tends to show up somewhere else. Body image does not automatically improve with weight loss — people arrive at their target weight and find the mirror has not delivered what they expected, particularly with loose skin. And rapid change in how you look changes how others treat you, which is more destabilising than people anticipate.
What about the reports linking these drugs to suicidal thoughts?
Here is the careful version. Case reports prompted formal regulatory review on both sides of the Atlantic. In January 2024 the FDA said its preliminary evaluation had not found evidence that GLP-1 receptor agonists cause suicidal thoughts or actions, while continuing to investigate. The European Medicines Agency's safety committee concluded that the available evidence did not support a causal association. Separately and importantly, the labelling for semaglutide in weight management advises monitoring for depression, suicidal thoughts or behaviour and discontinuing if they emerge. So: no established causal link, and a labelled instruction to watch for it anyway.
What should I do about that practically?
Tell your prescriber about any history of depression, anxiety, self-harm or eating disorder before you start, not after. If your mood worsens or you develop thoughts of harming yourself while taking one of these medications, contact your prescriber promptly and do not simply stop or continue on your own judgement. If you are in crisis, call or text 988 in the US now rather than waiting for an appointment. And if you have a history of an eating disorder, that is a specific conversation to have with a clinician before starting, because appetite suppression interacts badly with disordered eating patterns.
Check three things first
Is your state eligible — 28 are excluded. Does your plan apply a deductible to outpatient mental health, and have you met it. And what does your insurer's own in-network directory show, since it gets you the same economics with no intermediary. If you are in crisis, call or text 988 instead of reading further. We are paid $300 if you sign up here.
Visit Octave (affiliate link)Pricing statements and state exclusions verified 12 August 2026 and subject to change.
Compare Other GLP-1 Providers
See how other telehealth providers stack up.
CoreAge Rx
#1 RecommendedFlat-rate pricing for compounded semaglutide and tirzepatide with NABP-verified pharmacies
Read Review →LifeMD
Top RatedPublicly traded telehealth company with comprehensive health platform and competitive pricing
Read Review →Amazon One Medical
Brand-Name, No CompoundingFDA-approved Wegovy, Zepbound and Foundayo from $149/month cash, $25 with insurance and $50/month for eligible Medicare members — the first mainstream route to approved medication at prices that compete with compounded. We earn no commission from it
Read Review →PlushCare
Insurance AcceptedMajor telehealth platform with brand-name FDA-approved GLP-1s, insurance support, and 1M+ members treated
Read Review →Alan Meds
Top RatedAffordable compounded GLP-1s with board-certified physicians and straightforward pricing
Read Review →Mochi Health
Obesity Medicine SpecialistsBoard-certified obesity medicine specialists with both brand-name and compounded GLP-1 options
Read Review →Crisis resources and medical disclaimer
If you are having thoughts of suicide or self-harm, or are in acute distress, call or text 988 in the United States to reach the Suicide and Crisis Lifeline, available 24 hours a day at no cost. If someone is in immediate danger, call 911 or go to the nearest emergency department. This article is informational and is not medical advice, psychiatric advice or a substitute for assessment by a qualified clinician, and it cannot tell you what care you need. Tell your prescriber about any history of depression, anxiety, self-harm, substance use or eating disorder before starting any GLP-1 receptor agonist, and contact them promptly if your mood worsens or you develop thoughts of self-harm during treatment — do not stop or continue a prescribed medication on the basis of a product review. A history of an eating disorder warrants specific clinical discussion before starting appetite-suppressing medication. Insurance coverage, costs and provider availability vary by plan, employer and state; confirm your own benefits with your insurer.
Sources · date reviewed: 12 August 2026
- findoctave.com/individual-therapy — rendered in a browser on 12 August 2026, because ordinary requests to the site returned HTTP 403. Source for the statement that clients pay an average of $28 per session when paying through insurance; for the claim of being in-network for 33 million Americans; for the description of the US therapy market in 2025 as costing $100 to $250 per session, with the most expensive states at $150 to $250 per hour including New York, California and North Dakota and the least expensive at $120 to $130; for the existence of a free cost estimation tool; and for the description of a network of thousands of continuously-vetted therapists offering individual, couples and family therapy.
- findoctave.com/robots.txt — retrieved 12 August 2026. Explicitly permits crawling with Allow: /, disallowing only API, maintenance and certain location-finder paths, and imposing no restrictions on AI or Anthropic agents. The HTTP 403 responses we encountered were bot filtering rather than a robots restriction, which is why we read the site in a browser.
- Katalys offer listing #1311, retrieved 12 August 2026 — flat $300.00 commission, Health & Wellness vertical and Mental Health sub-vertical, United States targeting, sub-network Tune, conversion action Purchase. Source for the 28 excluded states listed in this review and for the named priority states of California, New York, New Jersey, Pennsylvania, Illinois, Florida and Texas, and for the advertiser's description of Octave as a direct-to-consumer therapy provider for individuals, couples and families addressing anxiety, depression, stress and burnout.
- In January 2024 the FDA stated that its preliminary evaluation of reports of suicidal thoughts or actions in patients treated with GLP-1 receptor agonists had not found evidence that these medicines cause such thoughts or actions, and that its review was continuing. The European Medicines Agency's Pharmacovigilance Risk Assessment Committee concluded following its review that the available evidence did not support a causal association between GLP-1 receptor agonists and suicidal thoughts or self-injurious behaviour.
- Labelling for semaglutide in weight management advises monitoring patients for depression, suicidal thoughts or behaviour, and discontinuing treatment if such symptoms emerge — a precaution applied to medicines used for weight management. This is the basis for our statement that no causal link has been established while a labelled monitoring instruction nonetheless applies.
- The 988 Suicide and Crisis Lifeline provides free, confidential 24-hour crisis support in the United States by call or text. Employee Assistance Programmes commonly provide a limited number of counselling sessions at no cost to employees. Health insurers maintain in-network provider directories that members can search directly. Community mental health centres, university training clinics and therapists offering sliding-scale fees provide reduced-cost options.
- In US health plans, a deductible applied to outpatient behavioural health means the member pays the full negotiated in-network rate for covered visits until the deductible is satisfied, after which cost-sharing moves to a copay or coinsurance — the basis for our caveat on the stated $28 average.
Limitations, stated plainly. We did not create an account, book a session, speak to a therapist or verify any clinician's credentials, and we make no assessment of the quality of care provided. Their site returned 403 to ordinary requests and we read it in a browser session; we reviewed the individual therapy page and homepage only. We have not verified their therapist credentialing or supervision process, their cancellation and no-show policy, their privacy and data practices, their complaint procedure, or how they identify and escalate clients whose needs exceed weekly outpatient therapy — that last point matters and is a question to ask directly. We did not use the cost estimation tool and quote no figure from it, and we could not verify the $28 average, the 33 million in-network claim or the therapist network size independently. State exclusions come from the affiliate listing rather than Octave's own eligibility checker. We could not reach independent review platforms. We did not contact Octave before publishing.
Affiliate disclosure
GLP1Drugs.org is paid a flat $300 for each conversion through the links on this page — more than seven times the largest commission on any other offer we carry, and paid for directing someone into mental health treatment. Because of that we have structured this review deliberately: the 988 crisis line appears above the product, the routes that pay us nothing appear above the praise, and the deductible caveat appears above the $28 headline. We have rated Octave 4.1 out of 5, flagged that this offer excludes 28 states, and told readers plainly that their own insurer's in-network directory delivers the same economics with nobody being paid a bounty for the introduction. No company reviewed here sees or approves our copy before publication.