When does paying cash for a doctor visit make more sense than using Medicare?
Medicare runs on a cost-sharing model: you pay a deductible, then 20% of each approved service, and the complexity runs through a portal your doctor manages, not you. Sesame inverts that structure — posted price, direct booking, payment at checkout. For an acute problem (a sinus infection, a prescription refill, a one-time dermatology question), the Sesame cash price is often lower than 20% coinsurance on the equivalent Medicare-billed visit, and faster by days. The calculus shifts for expensive procedures: once you've hit your Part B out-of-pocket ceiling, Medicare covers 100% — and no Sesame visit counts toward that ceiling. The right tool depends on the type of visit, not a blanket preference for either system.
Sesame Care
A direct-pay telehealth marketplace — search providers by specialty and price, see the cost before booking, and skip insurance billing.
Key Features
- Visit prices start at $34 for telehealth appointments — all posted on provider profiles before you book, with no bill arriving afterward
- Same-day and next-day appointment slots across urgent care, primary care, mental health, and specialist visits — no referral required to access specialists directly
- 10,000+ independently licensed, board-certified providers across 383 service types — urgent care, primary care, mental health, dermatology, cardiology, women's health, and weight management among them
- Labs, imaging, and specialist referrals at transparent cash prices — typically a fraction of what insurance-billed rates run
- SesamePlus membership ($14.99/month) reduces per-visit costs further — 200+ common generics at $0 per fill, including blood pressure, cholesterol, and diabetes medications
- No insurance account required and no prior authorization — no penalty for using Sesame on a given visit instead of routing it through Medicare Part B
Best for
Medicare enrollees who find the Part B cost-share or specialist wait time adds more friction than a cash visit would cost — and seniors without insurance who want a direct path to a licensed provider at a posted price.
Worth knowing
Cash-pay visits through Sesame do not count toward Medicare Part B deductibles or out-of-pocket maximums. For high-cost procedures or chronic conditions where cost-sharing eventually falls in your favor — once you've hit your Part B out-of-pocket ceiling, Medicare covers 100% — the insurance route is the better financial path. Sesame is most cost-effective for single, episodic visits, not as a substitute for long-term care management.
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Is telehealth worth it for seniors?
Sesame Care works like a marketplace: you search by specialty or condition, read provider profiles, see a posted price, and book — all without calling an office or navigating an insurance portal. There is no bill that arrives later and no explanation of benefits to decipher. Payment happens at booking, and what you pay is what was listed.
The platform draws two main groups: people without insurance who have no affordable path to a doctor, and insured patients who discover the cash price is lower than their copay or deductible. Medicare enrollees fall into the second group more often than expected — Part B cost-sharing, prior authorization requirements, and specialist wait times add friction and cost that a direct cash visit sidesteps.
Prices on Sesame are set by the providers themselves, not negotiated through an insurance network. That creates visible competition: providers on the same platform often charge different rates for identical service types, and the search function surfaces those differences before you book. For a specialist consultation, prices for the same appointment type can vary significantly between providers — something the insurance-billed system obscures entirely.
Frequently Asked Questions
Yes. Sesame is a cash-pay service, so it works regardless of your insurance status. Because you pay directly, the visit does not go through Medicare billing — this means no cost-sharing with Medicare, but also no credit toward your Part B deductible or out-of-pocket maximum. For many seniors, a $34–$75 Sesame visit is still less expensive than the 20% Part B coinsurance on an equivalent office visit.
Yes. All providers on Sesame are independently licensed and board-certified in their specialty. They are independent practitioners who use the Sesame platform — not Sesame employees. Each provider's credentials, training, and patient reviews are visible on their profile.
Yes, where clinically appropriate and legally permitted. Providers on Sesame can prescribe medications for conditions they assess during the visit — you receive the prescription and can fill it at any pharmacy. GoodRx coupons can be used to reduce prescription costs at the pharmacy.
Sesame covers a wide range of conditions — urgent care (cold and flu, sinus infections, UTIs, allergies), prescription refills, mental health (anxiety, depression, medication management), dermatology, women's health, weight management, and specialist consultations. Over 383 service types are listed on the platform. It is not appropriate for emergencies — call 911 or go to an ER for chest pain, difficulty breathing, or signs of stroke.
You might also consider
A few more products for seniors worth a look.
| Product | Price | Best for |
|---|---|---|
| Sesame Care This pick | $34–$149 | Medicare enrollees who find the Part B cost-share or specialist wait time adds more friction than a cash visit would cost — and seniors without insurance who want a direct path to a licensed provider at a posted price. |
| Audien Atom Pro 2 OTC Hearing Aids | $289–$289 | Seniors who want hearing help without managing an app, account, or smartphone pairing | An easy, low-pressure gift for a parent who's been putting off hearing aids because every option seemed too complicated. |
| Audien Atom X Touchscreen OTC Hearing Aids | $389–$389 | Seniors who want hearing aid controls without a smartphone app | A practical gift for a parent who's hearing-test-avoidant but comfortable with a simple touchscreen. |
| Elehear Beyond Pro OTC Hearing Aids | $599–$599 | Seniors who struggle most in noisy social settings — restaurants, family gatherings, crowded rooms — rather than quiet one-on-one conversation | A meaningful gift for a parent who's stopped going to noisy family events because keeping up with conversation has become exhausting. |
Prices are approximate ranges — check each retailer for today's price.
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Products on this page are not intended to diagnose, treat, cure, or prevent any medical condition. Content is for informational purposes only and is not a substitute for professional medical advice. Always consult your physician or a qualified healthcare provider before purchasing or using any health product.