Monument in brief: alcohol care billed by the visit
Monument treats alcohol use disorder over video, and it does one thing rather than five: physician appointments for medication, therapy with licensed clinicians, and a moderated peer community sit inside the same account. Billing runs per appointment instead of per month. Self-pay is $100 a session, and the company advertises $25 per appointment when visits run through insurance. That shape rewards people who want a medical assessment, a prescription and occasional check-ins, because stopping means simply not booking again.
The trade-offs are just as concrete. Per-session pricing climbs quickly if you want weekly therapy, medication and any lab work are paid separately, and the program cannot supervise alcohol withdrawal or give long-acting injectable naltrexone. Anyone reading a Monument review while drinking heavily every single day should treat that last limit as the deciding factor, well before price enters the conversation.
What you actually pay, and when
The self-pay route
Cash pay is $100 per session. Because the model charges per visit rather than per month, no recurring membership fee sits on your card between appointments, and your total depends entirely on how often you book. Two medical visits in a quarter cost far less than fortnightly therapy over the same period.
That is a genuine advantage for people who are cautious about commitment. It is also the reason the same program can look cheap or expensive depending on the care plan you and the clinician land on. Work out your likely cadence first, then multiply.
The insurance route
The company bills insurance, and advertises $25 per appointment on that route. Treat that figure the way you would treat any advertised in-network rate: what you personally owe depends on your plan design, whether your deductible is met, and how behavioral health visits are handled under your benefits. Call your plan, ask specifically about outpatient behavioral health and substance use telehealth visits, and get the copay in writing where you can.
Medicare and Medicaid rules differ again by program and state, and telehealth coverage terms have shifted repeatedly in recent years. The current federal position is worth reading directly on the Medicare telehealth coverage page before assuming a virtual visit is covered the same way an in-person one would be.
What the appointment fee does not include
The visit price buys clinician time. It is not a bundle. Expect these to sit outside it:
- The medication itself, paid at the pharmacy under your prescription benefit or cash price.
- Any lab work a prescriber orders, such as liver or kidney panels.
- Higher levels of care, including inpatient treatment or medically supervised detox.
Two payment routes with different economics deserve a side by side comparison rather than a guess, especially if you have a deductible left to clear this year.
Self-Pay vs. Insurance: Cost Structure at a Glance
| Self-Pay | Insurance | |
|---|---|---|
| Advertised per-session rate | $100 | $25 |
| Recurring membership fee | None | None |
| Medication cost | Paid separately | Under Rx benefit |
| Lab work | Paid separately | Varies by plan |
| Key variable | Visit frequency | Deductible & plan design |
Insurance or cash pay, which is cheaper
Going through insurance is not automatically cheaper. Deductibles, copays and prior authorisation can make a cash-pay programme the better deal.
Coverage is never something a programme can promise: plans decide, prior authorisation is routine for GLP-1 medicines, and denials are common. Confirm with your own plan before choosing.
Is Monument legit? Reading the record rather than the reviews
The third-party checks available, and the ones that are not
Legitimacy questions dominate searches for this brand, so here is the plain position. Our file carries no LegitScript certification for the company. LegitScript certifies telehealth and pharmacy operators against its standards, and its absence is not evidence of wrongdoing: plenty of legitimate behavioral health practices never apply, because the certification matters most for advertising controlled or high-risk products. It does mean one convenient outside check is unavailable to you, so you have to do more of the verification yourself. You can run any operator through the LegitScript certification lookup yourself in under a minute.
The public FDA enforcement record we track shows no warning letter against the company. FDA action against telehealth firms usually concerns marketing claims or unapproved products, and you can search the agency’s own warning letter database for any company you are considering.
How prescriptions reach your pharmacy
Our file also shows no Surescripts e-prescribing record for the company. Surescripts operates the network most US prescribers use to send prescriptions electronically. Without that record, the practical question to put to the clinic is simple: how does my prescription reach a pharmacy, which pharmacy, and how long does a refill take. Ask it during the first appointment rather than discovering the answer when you run low.
Pricing transparency
On transparency, the company scores better than much of the category. Both a cash figure and an insurance figure are published, and the per-visit basis is stated rather than buried behind a consultation. Prices do move, so confirm the session price and the insurance rate on the provider’s live site before your first booking. Our approach to weighting cost, clinical model and trust signals is set out in our scoring methodology.
Physician appointments and medication for alcohol use disorder
What the medical visit is for
The medical side of this program exists to answer three questions: how heavy and how frequent your drinking is, whether medication is appropriate, and whether your goal is abstinence or reduced drinking. Expect questions about daily volume, withdrawal symptoms such as shaking or sweating, other medicines you take, liver and kidney history, and any opioid use. Answer them precisely. Understating intake is the single most common way a virtual assessment goes wrong.
The medicines approved for alcohol use disorder
The FDA has approved three medicines for alcohol use disorder: naltrexone, acamprosate and disulfiram. The National Institute on Alcohol Abuse and Alcoholism sets out how each is used in its clinical overview of alcohol use disorder. Some clinicians also prescribe topiramate or gabapentin off label, meaning outside the approved labelling, when first-line options are unsuitable.
Ask which of these a prescriber here can offer you and why. That question does more work than any marketing page, because the answer tells you whether the assessment was tailored or templated. Broader treatment context sits in our medication guides index.
Dosing, monitoring and follow-up cadence
Label-supported use differs sharply between the three, which is why the choice is a clinical decision rather than a preference:
- Naltrexone is an opioid receptor blocker taken by mouth, commonly once daily. It must not be combined with opioid painkillers, and it can trigger sudden withdrawal in someone who is opioid dependent.
- Acamprosate is usually taken three times a day, which suits people who can keep to a schedule. Kidney function guides dosing, and it is generally avoided in severe renal impairment.
- Disulfiram works by making drinking physically unpleasant, so it only fits a committed abstinence goal and requires a clear understanding of the reaction it causes.
Full prescribing detail for each sits in the FDA labelling published on DailyMed. Whatever is prescribed, agree a follow-up date at the first visit. In a per-visit model, follow-up is something you book, not something that arrives automatically, and that is a meaningful difference from subscription programs where check-ins are baked into the fee.
Side effects and safety points worth raising
Nausea, headache, tiredness, sleep disturbance and appetite change are among the more common complaints across these medicines. Naltrexone labelling addresses liver considerations, and prescribers often check liver enzymes before or during treatment; disulfiram carries hepatic risk too. Acamprosate’s most common problem is diarrhea. Report yellowing skin, dark urine, severe abdominal pain, or persistent vomiting to a clinician promptly rather than waiting for the next booked session.
On effectiveness, keep expectations calibrated. A widely cited systematic review in JAMA found that naltrexone and acamprosate produce modest average reductions in drinking compared with placebo, which is useful but not transformative on its own. The evidence summary is available through PubMed. Medication combined with therapy consistently performs better than medication alone, which is part of why a program bundling both has a coherent design.
Where this program stops
Two limits matter clinically. The service cannot manage medically supervised withdrawal, and it cannot administer extended-release naltrexone injections, which require an in-person injection. If you drink heavily every day, stopping abruptly without supervision can cause seizures or delirium tremens, a medical emergency. The Mayo Clinic overview of alcohol use disorder describes the warning signs, and FindTreatment.gov locates in-person and residential programs. A virtual visit is the wrong front door for that situation.
Therapy with alcohol-focused clinicians
Format and cadence
Therapy runs with licensed clinicians over video, and sessions are booked individually like the medical visits. Ask two things before you start: what modality the therapist uses, and whether you keep the same therapist across sessions. Continuity matters more in alcohol treatment than in most one-off telehealth encounters, because progress is measured over weeks of behaviour rather than a single symptom check.
Moderation goals as well as abstinence
The program supports moderation goals alongside abstinence, which sets it apart from services that treat abstinence as the only acceptable outcome. For someone who is drinking too much but not ready to quit entirely, that is often the difference between starting treatment and postponing it indefinitely. It is not a clinical free pass: a clinician may still recommend abstinence if your history, liver results or withdrawal risk point that way.
Running the numbers on therapy frequency
This is where per-visit pricing bites. Weekly therapy at the self-pay session rate is a serious monthly commitment, and it is the main reason a program that looks affordable at one visit can become the most expensive line in your budget. Patients using the insurance route at the advertised per-appointment rate face very different arithmetic, assuming their plan covers behavioral health visits. Decide your realistic cadence before your first booking, then check whether that cadence is affordable on the route you are using. Related decision context sits across our editorial coverage.
The moderated peer community and group sessions
What group support adds between appointments
A moderated community is the part of this model that costs nothing extra per message and does work no appointment can. Cravings do not schedule themselves around booked visits, and having somewhere to post at 9pm on a Friday is a practical benefit. Moderation matters here: an unmoderated forum on this subject can become a place where bad advice circulates freely.
What a forum cannot do
Peer support does not adjust a prescription, assess withdrawal risk, or replace a licensed clinician. Treat it as reinforcement between clinical contacts. If you find yourself asking the community questions that should go to a prescriber, that is a signal to book a visit rather than crowdsource an answer. For crisis situations, use emergency services or a national helpline listed through SAMHSA, not a discussion thread.
The app and day to day tracking
Daily tools in alcohol programs generally cover drink tracking, goal setting and progress views, and their value is mostly behavioural: writing down what you drank makes the pattern visible. Confirm on the provider’s own site which tracking features are included with your account and whether they work without a booked appointment.
Quick tip: Track your baseline for a week before your first visit, so the clinician is working from real numbers instead of a recollection.
Signing up, step by step
The flow below is the shape to expect from a per-visit telehealth clinic. Confirm each detail at signup rather than assuming it.
Step 1: Create an account and complete intake
Expect questions on drinking frequency and volume, withdrawal symptoms, current medications, medical history and your treatment goal. This is the point where accuracy determines whether the plan you get is safe.
Step 2: Choose your payment route
Decide between self-pay and insurance before booking, since the cost per appointment differs substantially. If you are going through insurance, have your plan details to hand and verify behavioral health telehealth benefits first.
Step 3: Confirm your state is served
Clinician licensure decides where care can be delivered, so availability varies by state and can change as staffing changes. Check your state at signup. If it is not served, our telehealth provider directory lists other operators to consider.
Step 4: Attend the physician appointment
The first medical visit covers assessment and, where appropriate, a prescription. Ask about labs, which pharmacy will receive the prescription, and when the next check-in should happen.
Step 5: Add therapy or community as you need it
Because visits are booked individually, you control the mix. Some patients use medical visits only; others pair them with regular therapy.
Step 6: Stopping
Per-visit billing means stopping is mostly a matter of not booking again, which is far simpler than cancelling a long-term contract. Still confirm in writing whether any recurring charge, membership component or cancellation notice applies to your account, and how to close it and request your records.
How the three tracks compare inside one account
| Track | What it addresses | Who leads it | Cadence | Monitoring involved |
|---|---|---|---|---|
| Medical appointments | Assessment and medication for alcohol use disorder | Prescribing physician | Booked per visit, follow-ups scheduled by you | Possible labs, medication side effect review |
| Therapy | Drinking behaviour, triggers, moderation or abstinence goals | Licensed therapist | Booked per session, often weekly or fortnightly | Self-reported progress between sessions |
| Community and groups | Peer support and accountability between visits | Moderators | Ongoing access | None clinical |
Notice what is absent from every row: detox supervision and injectable medication. Those need an in-person setting.
Support, refills and escalation
Support quality is the hardest thing to judge from outside, and our file does not document response times or channels for this clinic. So treat it as a question rather than an assumption. Before your first appointment, ask how to reach the care team between visits, how long a message typically takes to be answered, and who covers urgent clinical questions after hours.
Refills deserve the same directness. With no Surescripts e-prescribing record on hand, ask exactly how a refill is issued, whether it needs a new appointment, and how many days ahead to request it. In alcohol treatment, a gap in medication supply is not a minor inconvenience; it is a relapse risk.
Escalation is the third question. Find out what happens if your drinking worsens, if withdrawal symptoms appear, or if a clinician decides you need a higher level of care. A good answer names a referral pathway. A vague answer tells you to keep an in-person option in reserve.
Privacy and what happens to your drinking data
Alcohol treatment records are among the most sensitive data a person can create, and telehealth accounts often mix two different regimes: protected health information handled by clinicians, and consumer app data collected by the platform. Those are not governed identically, and the difference is easy to miss.
Read the notice of privacy practices and the app privacy policy before you enter anything. Look for four things specifically: what categories of data are collected, whether any data is shared with advertising or analytics partners, whether your clinical records are held under HIPAA, and how to request deletion of your account data. If community posts are involved, check what identifying information other members can see.
Ask, in writing, whether treatment information can be disclosed to an employer, insurer or family member without your consent, and what the process is for correcting a record. A clinic that answers those questions clearly is telling you something useful about how it operates.
Who Monument suits, and who needs a different setting
This model fits people who want medical treatment for drinking without a monthly subscription, who are comfortable with video care, and who value having prescribing, therapy and peer support under one login. It fits particularly well if you have insurance that covers behavioral health telehealth, since the advertised per-appointment rate on that route changes the economics substantially. It also suits people whose goal is drinking less rather than quitting outright, because that goal is explicitly supported.
Look elsewhere if you drink heavily every day and may need supervised withdrawal, if you want extended-release injectable naltrexone, if you need intensive outpatient or residential care, or if you expect to attend therapy weekly on a cash budget where per-session costs compound. Anyone taking opioid medication needs an in-person conversation about interactions before naltrexone is considered at all.
Questions to ask before your first appointment
Questions to Ask Before Your First Appointment
- Which AUD medications can your prescribers offer, and which pharmacy will they use?
- Are labs required, who orders them, and who pays?
- Will I see the same therapist each session, and what approach do they use?
- What is my exact cost per appointment, and does anything else bill separately?
- How do I reach someone between visits for urgent questions?
- How is my drinking data stored, shared, and deleted?
- What is the referral pathway if my drinking worsens or withdrawal appears?
- Which medications for alcohol use disorder can your prescribers offer, and which pharmacy will they use?
- Are labs required, who orders them, and who pays for them?
- Will I see the same therapist each session, and what approach do they use?
- What is my exact cost per appointment on my route, and does anything else bill separately?
- How do I reach someone between visits, and what happens in an urgent situation?
- How is my treatment data stored, shared and deleted?
If you are switching from another provider, ask your current one for a copy of your records, confirm the date your last prescription runs out, and check whether any recurring charge continues after you stop booking. Then price the whole year rather than one visit, because that is the number that decides affordability.
What a year actually costs
Programmes quote a monthly headline. Add the medication, the labs and the renewal price and the real number is usually different.
Advertised prices change often and intro pricing rarely lasts. Ask what the renewal rate is before you commit to a plan.
Our free health and cost calculators handle the arithmetic, and a sample savings report shows the format we use when comparing routes.
Reputation check: reading the public record on Monument
Searching this brand name is unusually unhelpful, because it collides with arenas, national landmarks and a Colorado town. General results reveal almost nothing about the clinic, which is exactly why unattributed roundups about it should be ignored.
Go to named sources instead. The company’s Better Business Bureau profile shows complaint volume, complaint themes and whether the business responded, which is more informative than a star average. The Apple App Store and Google Play listings carry current ratings and recent written reviews; weight recency heavily, since staffing and support standards change faster than lifetime averages do. Read one star and five star reviews together and look for the same specific issue repeating, because a pattern carries weight that a single account does not.
Two extra checks cost nothing. State medical and behavioral health board lookups let you confirm the license of the clinician you are matched with. And any claim about certification or regulatory standing can be tested directly against the LegitScript and FDA records linked above. For a diagnosis this sensitive, the decision should rest on the documented complaint record, verifiable licensure, a privacy policy you have actually read, and the price confirmed on the provider’s live site.
Educational content, not medical advice. Always consult a qualified clinician before starting, stopping or switching treatment.