Telehealth visits peaked at 32% of all US clinical visits in April 2020. They have stabilized at roughly 6-8% — much higher than 2019, much lower than the peak. The platform landscape has consolidated. Three categories matter today: virtual primary care, mental health platforms, and direct-to-consumer prescription services. Each is useful for a different problem and dangerous for a different reason.
Traditional virtual primary care
The older players: Teladoc, Amwell, MDLive. Most users access these through employer-sponsored plans rather than directly.
What they are good for
- Acute issues like UTIs, sinus infections, basic skin conditions
- Medication refills for stable chronic conditions
- Low-complexity questions that do not need physical exam
What they are not good for
- Anything requiring physical examination
- Conditions where ongoing relationship with a clinician matters
- Urgent issues where response time is critical
Pricing without insurance is typically $75-100 per visit. With insurance, often $0-25.
Mental health platforms
Therapy: Talkspace and BetterHelp
Both offer text-based and video therapy at subscription rates of roughly $260-400 per month. The convenience is real. Quality varies more than in-person therapy because therapist matching is automated. Both have faced scrutiny over therapist working conditions and data-handling practices.
Psychiatric medication: Brightside, Cerebral, Done
Psychiatric medication platforms. Cerebral and Done faced regulatory action for over-prescribing of stimulants in 2022-2023. Both changed policies. If you need ongoing psychiatric care, in-person or hybrid is often preferable to fully virtual.
For most people seeking therapy specifically, the cheapest route is usually finding a therapist who takes your insurance directly, then video-calling through their existing platform.
Direct-to-consumer prescriptions
This is the fastest-growing telehealth category and the most ethically complex. Platforms like Ro, Hims, Hers, Nurx, and GoodRx Care offer narrow-scope prescriptions for ED medications, hair loss, contraception, and increasingly GLP-1 weight-loss drugs.
The model
Works because most of these prescriptions are low-risk and do not require physical exam. The criticism is that the business model incentivizes prescribing — the doctor’s role can feel pro forma. For weight loss in particular, rapid prescription of GLP-1s without long-term care planning has drawn regulatory attention.
What to look for
- Licensure of the prescribing clinician in your state. This is a legal requirement that platforms sometimes obscure.
- What happens after the prescription. Is there follow-up? Lab monitoring? Or are you on your own?
- Continuity with your other care. Does your primary care doctor know what was prescribed?
- What happens to your health data. Several telehealth platforms have been caught sharing data with advertisers in ways that violate basic norms.
Where telehealth still falls short
- Anything requiring physical examination — abdominal pain, suspicious skin findings, joint problems
- Anything urgent enough that response time matters
- Conditions where an ongoing relationship with a single clinician matters — chronic diseases, complex mental health
International picture
Telehealth uptake varies widely. UK’s NHS supports virtual visits within general practice. Many EU countries have integrated telehealth into national systems. Australia made COVID-era telehealth permanent. The US remains a patchwork of state-level rules.
Bottom line
Telehealth is useful for low-complexity acute care, established prescription refills, and many mental-health interactions. It is not a replacement for a primary care relationship and not appropriate for anything requiring hands-on assessment. Treat direct-to-consumer prescription services with extra caution — convenience can hide poor medical practice.
