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Online therapy provides individuals seeking guidance from licensed therapists with a convenient and flexible alternative to traditional in-person sessions. One crucial aspect to consider when choosing an online therapy provider is insurance coverage, which makes mental health services more affordable for many individuals.
According to recent studies, 21% of adults in the United States experience at least one form of mental illness, underscoring the pressing need for accessible mental health care options. The cost of therapy sessions can often be a significant barrier for those seeking treatment.
Fortunately, online therapy providers that accept insurance help alleviate this financial burden, enabling individuals to receive the support they need without worrying about out-of-pocket expenses.
Here, we list the best online therapy services that take insurance or support insurance reimbursement.
Our Top 10 Best Online Therapy That Takes Insurance in 2023:
Talkspace- Best online therapy that takes insurance overall
Thriveworks - Best for face-to-face therapy alternative
BetterHelp - Best selection of licensed counselors
BrightSide - Best for treating depression and anxiety
Our Methodology: How We Reviewed the Best Online Therapy Services That Take Insurance
To help narrow down your options, we’ve analyzed user reviews given by real patients to find the most trusted and accredited online therapy services available. We compared several important key factors to create our list of providers, including:
Price and affordability
Therapist certifications (PsyD, Ph.D., LCSW, LPS)
Available methods of communication (text messaging, voice calls, video calls)
Reviews and overall customer satisfaction
These services not only accept insurance but are also some of the best online therapy options on the market.
Looking for affordable online therapy?BetterHelp offers affordable pricing plans and a service you can trust. While they may not accept insurance, you can apply for reimbursement via your insurance provider.Visit Site
Our 10 Best Online Therapy That Takes Insurance - Reviews:
Here's a round-up of the top 10 online therapy providers that take insurance, so you can choose the one that fits you best.
1. Talkspace
Best for: Busy professionals seeking highly tailored online therapy
Session Types: Text, video, and audio messaging; live video sessions (for Premium and Ultimate plans)
Is insurance accepted as a form of payment? Yes
Talkspace stands as a leading online therapy platform, acclaimed by millions for its comprehensive mental health services. This user-friendly platform provides dedicated support for conditions such as depression, anxiety, and addiction, going beyond standard services to also offer psychiatric evaluations and medication management.
Unique to Talkspace is its range of therapy options, including individual, couples, and teen counseling, catering to diverse needs. Its innovative matching system ensures clients connect with the most suitable therapist and the flexibility to switch therapists at no extra charge guarantees a comfortable, personalized therapy experience. With Talkspace, you're always in the right hands for your mental health journey.
What Insurance Does Talkspace Accept?
Talkspace accepts most major insurance companies, including Aetna, Blue Cross Blue Shield, Cigna, GatorCare, Optun, Premera, and more. Although Talkspace isn't available through Medicare or Medicaid, they do partner with several U.S. healthcare providers, Employee Assistance Programs (EAP), and educational organizations.
Cost and Payment Options
Talkspace has three available plans. If you don't have health insurance, prices can vary from $69 to $109 per session.
Messaging Therapy (starting at $69 per session) provides a private chatroom where you can send messages to a licensed therapist but does not include live sessions.
Video Plus Messaging Therapy (starting at $99 per session) includes a private chatroom and four 30-minute live therapy sessions per month.
Video Plus Messaging Plus Workshops (starting at $109 per session) Includes everything from the first two plans, in addition, to live group workshops, which are held via Zoom and led by licensed therapists.
They also offer psychiatric services outside of their messaging therapy, starting at $249 for an initial evaluation and then $125 for every follow-up visit.
However, if you have insurance, the company estimates that up to 100% of your monthly cost might be covered; although survey respondents reported spending an average of $150 each month without insurance coverage.
Why we choseTalkspace: We chose Talkspace for its convenient peer-reviewed therapist-matching algorithm, ensuring you find a specialist tailored to your needs.
Our Experience: Talkspace offers a user-friendly platform for clients to feel supported and understood. The live video sessions, along with unlimited messaging, provided us with an engaging and personalized therapy experience.
Pros:
Choose your therapist and switch therapists at no extra cost
Best for: Those seeking online therapy with the option to meet your therapist face-to-face
Session Types: In-person, phone calls, video calls, and app-based messaging
Is insurance accepted as a form of payment? Yes
Thriveworks is a comprehensive platform delivering online therapy and counseling services, addressing a broad spectrum of mental health concerns, including anxiety, depression, stress, trauma, and relationship problems.
This user-friendly service offers flexible scheduling options, providing sessions through multiple channels such as phone calls, video conferencing, in-person consultations, or even app-based messaging. With a focus on accessibility and convenience, Thriveworks makes mental health care more approachable and manageable for everyone, ensuring professional help is just a click or call away.
What Insurance Does Thriveworks Accept?
Thriveworks accepts most major insurance plans such as Aetna, Blue Cross Blue Shield, Cigna, Humana, Medicare, and United Healthcare. This ensures affordable treatment options for their clients with the backing of a wide network of licensed mental healthcare professionals.
Cost and Payment Options
Thriveworks offers a membership program at $99 per month. This includes:
One therapy session per month
Access to their therapy app for scheduling and messaging
Exclusive video content focused on mental health and wellbeing
Additional individual therapy sessions are available at varying rates based on factors such as location and therapist specialty.
Why we chose Thriveworks:The accessibility and flexibility in scheduling sessions make Thriveworks stand out, allowing clients to choose from a variety of session types to best suit their individual needs.
Our Experience: The attentiveness and expertise of the professionals made the experience feel personalized and efficient. Access to the therapy app for messaging and scheduling, as well as the exclusive video content related to mental wellbeing, further added to the comprehensive nature of the service.
Pros:
Wide range of mental health concerns addressed
Flexible and convenient scheduling, including in-person sessions
Network of experienced and highly-trained professionals
Accepts most major insurance plans
Cons:
Monthly membership fee required, but additional sessions may incur extra costs
Individual session prices may vary based on multiple factors
Best for: First time therapy goers who will need guidance finding the right therapist for them
Session Types: Text, live chat, video call, phone call
Is insurance accepted as a form of payment? No, but you can apply to get reimbursed by your insurance provider
BetterHelp is rated as one of the best online counseling services in the industry. With over 30,000 licensed therapists, BetterHelp is available for individuals, couples, and teens via SMS, chat, phone, and video sessions.
They offer various types of treatments for conditions like depression, anxiety, addictions, and anger management, and will match you with a therapist in just 24 hours of signing up. While BetterHelp doesn't accept insurance as a form of payment, they offer affordable prices on therapy, and you may apply for partial reimbursement with your insurance company.
Cost and Payment Options
BetterHelp tailors your treatment plan according to what you're struggling with. The cost ranges from $60 to $90 per week, billed monthly through credit card or your PayPal account - so your monthly charge will be somewhere between $240 and $320.
Why we chose BetterHelp: BetterHelp's commitment to matching clients with therapists that best meet their needs and preferences showed a high degree of personalization. We also valued BetterHelp's dedication to continued learning, as evidenced by their comprehensive library of mental health resources.
Our Experience: We appreciated the broad range of therapists available on BetterHelp, which helped tailor the service to our needs. The platform's app was straightforward to use for communication and appointment scheduling.
Best for: Individuals experiencing depression or anxiety
Session Types: Video calls, phone calls, and app-based messaging
Is insurance accepted as a form of payment? Yes
BrightSide is a leading provider of affordable online therapy and behavioral health services, specializing in Cognitive Behavioral Therapy (CBT) and medication management. With a user-friendly website and convenient mobile app, BrightSide offers accessible talk therapy to address a wide range of mental health concerns. From depression and anxiety to ADHD and other disorders, their comprehensive approach ensures personalized care for every individual.
What Insurance Does BrightSide Accept?
BrightSide accepts in-network insurance coverage through numerous providers such as Aetna, Cigna, Medicare, and more—offering affordable and accessible treatment from one of their many professional therapists.
Cost and Payment Options
BrightSide offers different plans ranging from $95 to $349 a month:
The Psychiatry Plan, costing $95 a month, includes a comprehensive evaluation with a psychiatric provider as well as ongoing support and any necessary adjustments to your plan.
The Therapy Plan, priced at $299 a month, includes four video sessions and unlimited messaging with a licensed therapist. You can also add additional 45 minute video appointments for $59 per session..
The Medication and Therapy Plancosts $349 per month and combines the benefits of the other plans, including evaluation and diagnosis. A licensed therapist replaces the counselor in this plan, allowing them to monitor your medication treatments and communicate with your physician.
Why we chose BrightSide: We chose BrightSide for its data driven platform that helps you keep track of your symptoms through helpful bi-weekly questionnaires. With its network of licesnes professionals and its use of evidence based-methods, BrightSide makes the extra effort to help you prioritzie your mental health.
Our Experience: BrightSide's integration of therapy and medication management added an extra layer of support, while the consistent access to a dedicated care team ensured personalized treatment tailored to individual needs.
Pros:
Online therapy and medication provision
Collaborative care model for maximum, holistic care
Best For: Individuals seeking on-demand access to a diverse network of mental health professionals
Session Types: Messaging and live video calls
Is insurance accepted as a form of payment? Yes
LiveHealth Online is a trusted platform that offers secure and convenient access to licensed healthcare professionals directly from your computer or mobile device. Their comprehensive mental health services encompass both therapy and psychiatry, providing support for a wide range of conditions including anxiety, depression, stress, and bipolar disorder.
What Insurance Does LiveHealth Online Accept?
LiveHealth Online is partnered with numerous insurance providers including Aetna, Anthem, Blue Cross Blue Shield, Cigna, and UnitedHealthcare, among others. This broad insurance acceptance makes it possible for many users to receive quality mental health care at a reduced cost.
Cost and Payment Options
LiveHealth Online offers therapy sessions at a standard fee of $95 per session, while psychiatry sessions start at $175 for the first visit and $75 for follow-ups. However, the actual cost can be significantly less or even zero, depending on your insurance coverage.
Why we chose LiveHealth Online: LiveHealth Online's accessibility, broad range of mental health services, and extensive insurance coverage set it apart. The platform's commitment to providing quality mental health care services at affordable rates makes it a commendable choice for those seeking professional help for mental health concerns.
Our Experience: LiveHealth Online provided a seamless and efficient way to connect with highly skilled mental health professionals. The added advantage of psychiatry services offered an integrated and holistic approach to mental health care.
Pros:
Access to both therapy and psychiatry services
Wide range of accepted insurance providers
Convenient and flexible scheduling
Cons:
Sessions could be cost-prohibitive without insurance
No messaging or phone call option for therapy sessions
Best for: Individuals looking for a low-commitment therapy and medication management option
Session Types: Video
Is insurance accepted as a form of payment? Yes
Amwell has more than 350 licensed psychologists and social workers. Therapy sessions last about 45 minutes and there are licensed therapists on-call to provide treatment whenever you need it most. Amwell offers a feature that allows you to turn off your camera so that the virtual therapist can't see your face during the sessions, and you are guaranteed the highest level of privacy and comfort
What Insurance Does Amwell Accept?
Amwell is one of the most reputable places for online therapy that takes insurance. Working with approximately 50 different carriers—like Aetna, Anthem, Blue Cross Blue Shield, Medica, UnitedHealthcare, and WebTPA—Amwell brings affordable online therapy to many people across the country.
Cost and Payment Options
Amwell doesn't offer bundled service packages or subscription plans. You pay for each session at the time of booking and prices depend on your therapist's experience level and whether you're covered by insurance. Sessions with licensed therapists are between $109 and $129 per appointment depending on where you live. Psychiatrist appointments cost $279 for the first visit and then $109 for each follow-up visit.
Why we chose Amwell: Amwell stands out for its 24/7 availability, offering immediate access to mental health professionals even during weekends and holidays. The HIPAA-compliant service ensures clients' privacy, while the versatile platform supports individual, couples, and teen counseling, catering to a wide range of therapy needs.
Our Experience: We appreciate Amwell's subscription-free model, allowing users to access their services without signing up for a subscription. The convenience of scheduling appointments with therapists and obtaining prescriptions without visiting a doctor's office creates a seamless experience for those in need of immediate mental health care.
Best for: Busy individuals needing flexible scheduling and the option for same-day appointments.
Is insurance accepted as a form of payment? Yes
MDLive therapists can help you work through a huge range of mental health issues, including addiction, depression, eating disorders, grief, LGBTQ support, trauma, stress, and more. Their licensed therapists have an average of over 10 years of experience. MDLive’s online services come highly recommended and they have already helped millions of people find the support they need.
What Insurance Does MD Live Accept?
MDLive works with both Medicare and employer-provided insurance plans, as well as private insurance plans that cover virtual doctor’s visits. MDLive is HIPAA-compliant and holds a strict code of ethics to uphold the privacy and safety of its patients.
Cost and Payment Options
Without using insurance, each 45-60 minute therapy session with MDLive costs $108. For appointments with psychiatrists, an initial 30-minute session would cost $284, and every follow-up session after that costs $108 for a 15-minute session.
Why we chose MDLive: MDLive's seamless integration with major EHR (Electronic Health Record) systems sets it apart, facilitating efficient coordination between primary care providers and mental health professionals. The platform offers secure video and phone sessions covering various therapy areas, accommodating clients' diverse needs.
Our Experience: We like the flexibility that MDLive offers to choose how many sessions you would like without having to pay for a monthly subscription. You can also schedule an appointment right away and some providers even offer same day and weekend sessions. The provider profiles available on the site also offer a great way to get a sense of their personality as well as their areas of expertise
Best for: Those seeking telehealth care that includes all common medical services
Is insurance accepted as a form of payment? Yes
Doctor on Demand has a team of therapists and psychiatrists that have been rated 4.9 out of 5 by patients. You'll begin the signup process by filling out a questionnaire, and Doctor on Demand will match you with a therapist who specializes in your area of concern.
Alternatively, you can browse the network - it's easy to find a therapist based on their background and qualifications. Doctor on Demand psychiatrists can also prescribe medication as part of the therapy session.
What Insurance Does Doctor on Demand Accept?
Doctor on Demand accepts many insurance plans, including United Healthcare, Cigna, Humana, and Aetna. They have also made it easy to check if your insurance company is covered, which you can do when you register.
Cost and Payment Options
Doctor on Demand doesn't have monthly subscription plans, so talk therapy sessions cost $129 for a 25-minute session and $179 for a 50-minute session. Psychiatry sessions cost $299 for your first 45-minute session, then follow-up psychiatry appointments will only cost you $129 each (for 15 minutes).
Why we chose Doctor on Demand: Doctor on Demand's strong emphasis on integrating mental health care with overall medical care sets it apart, offering clients a comprehensive approach to well-being. The platform's user-friendly interface streamlines appointment scheduling, while board-certified mental health professionals provide customized treatment plans to suit individual needs
Our Experience: We found the Doctor on Demand service to be streamlined and convenient. The doctors are prompt, compassionate and able to fill a prescription without hassle. Professionals are available 24/7 so you can receive the care you need anytime.
Best for: Those seeking strong emphasis on cognitive behavioral therapy
Is insurance accepted as a form of payment? No, but you can apply to get reimbursed by your insurance provider
Online-Therapy.com uses cognitive behavioral therapy to help empower and motivate people to live happier, more productive lives. Online-Therapy.com was developed to help people first identify challenging and dysfunctional thoughts, behaviors, patterns, and emotions.
Then—together with licensed professionals—patients work through and overcome even the longest-standing issues. If your insurance covers online therapy, you'll be able to request partial reimbursement or direct payment for sessions with Online-Therapy.com.
Cost and Payment Options
Subscription plans at Online-Therapy.com start at only $40 a week (after a 20% discount given on the site), granting you access to the therapy program, which includes daily contact with your therapist available Monday through Friday, as well as a variety of tools on the website that will help you through your everyday struggles. There are three plans to choose from:
The Basic plan - For about $160 a month, this plan includes five days of messages from your therapist. It also has 8 hours worth of material - 25 worksheets, yoga and meditation videos, journals, activity plans, and self-tests - all accessed through an easy-to-navigate site.
The Standard plan - For around $240 per month, this plan is the same but with more flexibility to contact your therapist outside office hours and twice weekly meetings with them for 1 hour each day.
The Premium Plan - If you want 24/7 access to someone who really knows how to listen to what you're saying then go for the Premium plan at just over $320 a month which offers guaranteed express replies along with unlimited live video sessions (for 2 hours at once) throughout the week.
Why we chose Online-Therapy.com: The platform offers a user-friendly interface that simplifies the therapy process. Additionally, Online-Therapy.com offers flexible scheduling options, making it convenient for anyone seeking immediate mental health care.
Our Experience: The platform goes the extra mile by offering a wide range of supplementary resources, including educational materials, guided meditation exercises, and progress-tracking features. These elements work together to empower clients to continue their journey of self-improvement.
Compare the 10 Best Online Therapy Services Covered by Insurance
Provider
Session Types
Types of Therapy
Cost (without insurance)
Talkspace
Video, phone, messaging
Couples, individual, medication management, psychiatry, teen counseling
$276-$436 per month
Thriveworks
Phone, video, in-person therapy
Individual, couples, psychiatry
$65-$140 per session
BetterHelp
Video, phone, messaging
Individual, couples, teen
$240-$320 per month
BrightSide
Video, messaging
Invidual, medication management
$75-$87.25 per session
LiveHealth Online
Phone, video
Individual, children 10 and up, medication management
$80-$95 per session
Amwell
Phone, video
Psychiatry, therapy
$109-$129 per session
MDLive
Phone, video
Talk therapy, psychiatry
$108 per session
Doctor on Demand
Phone, video
Coaching, therapy, psychiatry
$129-179 per session
Online-Therapy.com
Video, phone, messaging
CBT therapy
$160-$320 per month
How to Find Online Therapy That Takes Insurance
In recent years, there has been a significant shift in the insurance industry regarding coverage for alternative therapies, including telehealth and telepsychology. This change has made it easier for individuals to access professional support for various mental and emotional health issues. While insurance coverage for online therapy varies by provider, some platforms work more closely with insurance companies to offer coverage options for their users.
Insurance coverage for online therapy ultimately depends on the policies of each individual insurance company. Some providers may not cover online therapy, while others may offer only partial coverage. In the case where an online therapy service is not covered by insurance, it may still be possible to apply for reimbursement or partial reimbursement through your insurance provider.
If you're considering online therapy, it's important to understand the specifics of your insurance coverage and what options are available to you. Some providers may require a co-pay or deductible, while others may have limits on the number of sessions covered. It's also essential to find a reputable online therapy provider that is licensed and accredited to ensure that you receive quality care.
Using Your Insurance to Cover the Costs of Online Therapy
Understanding Coverage Options: Total Coverage and Reimbursements
If your insurance provider does cover telehealth services, it will generally be in one of two ways:
Total coverage - The most preferable option for patients with insurance is an online therapy company that accepts insurance. In these cases, the online therapy company bills the insurance company, and the health plan pays the service directly for counseling services, medication, and support.
Reimbursements - Some insurance companies will cover part or all of the cost of online therapy through reimbursements. This means you will have to pay out of pocket for the sessions, but the insurance company will pay you back.
In this case, you'll need to make a claim to your insurance company. You should note two important things about reimbursements:
Make sure that you have all of the proper documentation needed to make an insurance claim. Different insurance providers will require different documents. So, check with your policy to see what you need beforehand, then make sure you have those documents when submitting your claim. Required documents can include receipts and copies of the online therapy license, among other items.
Some insurance companies are still figuring out their own policies. So, it is possible that your claim for reimbursement may be denied even though your policy states that online therapy is covered. If this happens, you will need to file an appeal with your insurance company.
If you find that your insurance plan will not help with online therapy costs, there are other ways to get more affordable online mental health care. While there are no free licensed therapists online, many therapists offer a sliding-scale pricing structure.
This can help you if you don’t have insurance coverage and you can’t afford the full price for your sessions. Many therapists offer discounts, reduced rates on bundled sessions, and payment plans. Bottom line: money concerns shouldn’t stop you from getting the help you deserve and need.
Selecting the Right Service to Match Your Insurance Requirements
To get the most out of your insurance coverage for online therapy, be sure to follow a few simple guidelines, including:
Reviewing the Details: Ensuring Coverage and Benefits
The first step in finding online therapy that takes insurance is checking to see if they accept your insurance coverage. Several companies provide online therapy that is covered by insurance, while others may advocate for you to help you get some form of compensation.
On the other hand, you may not want to limit yourself to the services that take your insurance policy. Online therapy costs significantly less than traditional therapy. If you are willing to pay out of pocket for your sessions, you'll have a lot more options and an easier process of selecting a therapist to help you with your concerns.
Comparing Online Therapy That Accept Insurance
When comparing different online therapy options, it is essential to consider several factors to determine which one is the best fit for you.
Cost: It's important to consider the cost of the services. Look for providers that offer transparent pricing, including any additional fees. Some providers may offer sliding scale options which allows individuals to pay for services based on their income and financial situation.
Therapy Methods: Different providers may use different therapy methods, such as cognitive-behavioral therapy, psychodynamic therapy, or mindfulness-based therapy. Consider which method may work best for you and choose a provider that offers it.
Medication Management:If you require medication for your condition, it's important to find an online therapy provider that offers medication management services. This may involve working with a psychiatrist or other medical professional to manage your medications and ensure they are working effectively.
Conditions Treated: It's important to choose an online therapy provider that has experience treating your specific condition. Some providers may focus on specific areas, such as anxiety or depression, while others may offer a broader range of services.
Session Types: Online therapy providers may offer different modes of communication, such as video conferencing, phone calls, or messaging. Consider which works best for you and choose a provider that offers that option.
Scheduling Your Online Therapy Session with Insurance Coverage
There are a few things to keep in mind if you're about to sign up for online therapy services:
Find out if the service you are interested in offers a free trial
When signing up, make sure you are aware of any extra fees such as one-off consultation or membership fees
You should also set up your virtual space to be free from distractions, with a stable internet connection, and a working mic and webcam
How Much Does Online Therapy With Insurance Cost?
Depending on what coverage or copay options you get from your insurance or employer, an online therapy session can range from $0 and $200. This is a bit cheaper than traditional in-person therapy.
Prices usually vary due to therapist availability, the state you’re from, your treatment plan, or the online therapy service.
What if My Insurance Doesn't Cover Online Therapy?
Online therapy has revolutionized the mental health field as we know it, though some insurance companies haven’t caught up to covering it. There are a few solutions available if your insurance doesn’t pay for online therapy.
Firstly, you can seek out sliding scale options or promotions for online therapists. If you’re a student or employee, you can most likely get discounts through your university or workplace. If you have a therapy training clinic in your area, you can get low-cost mental health help from students who need the experience.
Do Online Therapy Providers Take Medicaid or Medicare?
You can see if an online therapy provider takes Medicaid or Medicare by contacting their customer support. Medicare has extended its coverage for online therapy services to all recipients.
Medicaid coverage depends more on the state that you live in. Call Medicare or Medicaid and see if they cover the online therapy provider of your choice.
Accessing Quality Therapy Has Never Been Easier
There exists a wide range of online therapy options and luckily more and more of these services are accepting insurance. Choosing the right provider depends on your individual needs.
Our picks for the top 10 best online therapy that takes insurance are Talkspace, Thriveworks, BetterHelp, BrightSide, LiveHealth Online, Amwell, MDLive, Doctor on Demand and Online-Therapy.com.
Frequently Asked Questions
Will my insurance cover online therapy?+-
Most insurance providers have established new procedures for covering online therapy for both existing and new patients. However, coverage for telehealth services and doctors on demand may vary, depending on your carrier and where you live.
Does Medicaid pay for online therapy?+-
Yes, Medicaid insurance does cover online therapy. You’ll receive the same coverage whether you’re seeing a therapist online or in person. However, since this policy was created specifically for the pandemic, Medicaid may revisit it in the future. So, if you’re thinking about getting online therapy, it’s best to check directly with Medicaid first.
What kind of online therapy services accept insurance?+-
Not all telehealth services take insurance, but most of them do. Most insurance providers require a diagnosis for covering online therapy costs. So, marriage counseling, for example, would usually only be covered if one of the partners has been diagnosed with a mental health disorder. The specific coverage for online therapy sessions depends on factors such as your insurance plan, which therapist you choose, and where you live.
Does BetterHelp take insurance?+-
BetterHelp doesn't accept insurance, but you can try getting reimbursed by your insurance company if you have a doctor's diagnosis for your condition. In addition, their subscription prices are much more affordable than traditional therapy and range from $60-80 per week, which are billed monthly.
Nicky Lowney is an accredited health communication expert and writer for Top10. Having worked extensively in the pharmaceutical industry, Nicky specializes in translating complex medical information into content that informs and helps people. Nicky has also written for Tufts University School of Dental Medicine, and Decision Resources Group, among others.
The author of this article has been paid by Natural Intelligence to write this article. Neither the author nor Natural Intelligence provide medical advice, diagnosis, or treatment. If you think you may have a medical emergency, call your doctor or your local emergency number immediately.
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