HealifyNow vs Pettable: Compare ESA Letter Services (2026)

If you are looking for an ESA letter online, chances are that you have come across HealifyNow and Pettable. The similarity between these two is that both services provide access to licensed professionals through telehealth, and both claim not to have an instant approval process. Then how do they differ?
The following table shows the comparison between the two services on price, process, speed, refunds, state laws, service dog letters, and add-ons, to help you make the right choice.

Quick Comparison

What Both Services Have in Common

• Professionals who are licensed. In both cases, the letters are signed by licensed mental health or medical professionals.
• True evaluation. Both use a personal consultation, not an online test.
• No “registration.” There is no ESA registry, and neither organization can claim that the registration is necessary by law.
• For housing only. The letter helps get accommodation for housing needs only. It does not allow public access or air travel.
• State-specific requirements. Both cater to states like California, where the client-professional relationship must be longer than in other states.

Pricing

HealifyNow: $129 for 2 pets and $199 for 3 pets and more. The price is constant across all the states. In case of a PSD letter, $149 for 2 dogs and $229 for 3 dogs. No booking fees; you pay only in case of the clinician’s approval of the letter.

Pettable: Third-party review pricing for ESA letter ranges from 99-169, one letter covering 2 pets provided the therapist agrees with both. 3 pets and more mean that the additional letter should be purchased. Pettable also offers the monthly subscription program called “Value Bundle”, $14.99 a month, consisting of a discount on the letter, annual renewals, and a veterinary hotline.

What to compare: Price overall with respect to the number of pets, renewal, and upfront vs. approved payment.

How the Process Works

HealifyNow

• Register for free and complete a brief survey (about 5 minutes).
• Consult with a licensed professional via phone or video call (about 5 to 10 minutes).
• Should you be accepted, you will then pay and receive your letter by email, generally within 10 minutes.

Pettable

• Fill out the assessment form and make an appointment.
• Have an online consultation via phone with the clinician assigned to you.
• Should you be accepted, the clinician will send your letter to your portal for viewing and printing.

Key difference in structure: In HealifyNow, you pay after being accepted, but in Pettable, you pay at the time of booking and get refunded in case of rejection.

Speed

• HealifyNow: Delivery about 10 minutes after approval, with a short evaluation.
• Pettable: Delivery commonly within about 24 hours, with an express option and same-day letters sometimes available.

Both can be fast outside states with waiting periods. In California, Arkansas, Iowa, Louisiana, and Montana, laws on client-provider relationships mean you should plan for at least 30 days.

State Rules: California and Beyond

As per California’s policy for ESA letter issuance, there must be a prior relationship between the provider and the client for 30 days. Both organizations state that they follow this policy.

• HealifyNow: You will get the intent letter right away following the phone conversation, and the ESA letter following the day-30 follow-up visit.
• Pettable: Needs a 30-day relationship and two consultations in California.

Other states have their own rules too, so always ask a provider how its process fits your state. See our guides to California ESA letter requirements and Texas ESA letter requirements.

Refunds and Guarantees

HealifyNow: If the landlord does not take the ESA or PSD letter, you will receive 100% of your fee back on the same day without any questions.

Pettable: They provide you with a refund if you do not get approved by the clinician. According to reviews, you will get a refund if your landlord does not sign your letter after complaining to HUD. Look into the criteria first.

Points to consider while using these services:

• Is it for the refusal of landlords? Documentation involved?
• How to request a refund? Timeliness?

Service Dog Letters

If your dog is individually trained for performing duties related to a psychiatric disability, then maybe getting a psychiatric service dog letter will be more beneficial than an ESA letter.

• HealifyNow provides PSD letters starting at $149 for up to 2 dogs, for housing and employment purposes with a task-trained dog.
• Pettable is another company that provides PSD letters and also online PSD training resources.

Remember that a service dog is defined by task training, not by a letter, and that the ADA doesn’t require certification. See our guide to a service dog letter from a doctor.

Extras and Add-Ons

• HealifyNow: An extensive telemedicine service that offers a free first consultation, an availability of a care team every day between 7 am and 11 pm, and other services besides ESA letters.
• Pettable: A pet-oriented ecosystem, with an option for the bundle plan, annual renewals, a veterinarian hotline, and dog training services.

Choose according to your needs. For those interested in pet-specific services, Pettable is worth considering; for those preferring an easygoing and pay-only-if-approved system, HealifyNow may be more appropriate.

Reviews and Reputation

Both companies display third-party review badges. Pettable has a profile on ConsumerAffairs with a 4.7 rating from more than 800 reviews, and HealifyNow displays review badges from several platforms.

• Read recent reviews, including critical ones, on independent sites
• Look for patterns about refunds, scheduling, and communication
• Check whether companies respond to complaints
• Remember that reviews reflect individual experiences

Who Might Prefer Which?

You might lean toward HealifyNow if you:

Only want to pay once your letter is approved by a professional
Interested in a uniform cost across all states
Looking for a quick evaluation and fast delivery once it is approved
Desire PSD and ESA letters from one company

You might lean toward Pettable if you:

Need a yearly subscription package with perks such as a veterinarian hotline
Interested in online dog training information
Seeking a refund option dependent on the landlord accepting it
Both options are not for everyone. It is best to compare terms before deciding.

What No ESA Letter Provider Can Promise

In May 2026, HUD rescinded its previous ESA guidance and indicated that it would pursue housing instances in which there are animals specially trained for individual disabilities. There was no amendment to the Fair Housing Act, but the state law is relevant. As a consequence of this announcement, the following points become valid:

• The vendor cannot assure landlord’s approval. Be careful if someone guarantees “100% guaranteed landlord approval.”
• The state law becomes very important. States like Florida, Utah, Virginia, Ohio, New York, Arizona, and Nevada are doing better regarding state-based ESA grounds.
• There can be no assurance about the waiver of pet fees. You need to consult with your landlord.
• Evaluation and requesting in writing become extremely important.

How to Choose an ESA Letter Provider: A Checklist

• Professional with the right to work on you legally in your state
• Physical evaluation done by a living professional, not an instant evaluation
• Pricing information for multi-animal coverage and renewals
• Compliance with state laws, particularly if you are from California or other states with a waiting period
• Refund policy when denied or landlord disagrees
• Support available when a landlord requests verification of the letter
• Contents of the letter explained – license, date of signing, signatures, and contact info
• No need to register or have identification since no such thing exists officially
• Independent reviews

Red Flags With Any ESA Provider

Beware of websites that:

• Offer instant or guaranteed approval
• Fail to provide proof that a licensed professional will assess you
• Sell ESA “registration,” certificates, IDs, or vests as proof
• Claim that a landlord “must” accept their letter and waive all fees
• Promise you that your ESA can travel in the aircraft cabin
• Include hidden fees during the payment process
• Lack contact information, refund policy, and privacy policy

Also keep in mind that some landlords use third-party verification platforms, such as PetScreening, which may charge their own fees regardless of which provider issued your letter. See our guide on whether PetScreening is required.

Final Thoughts

Both HealifyNow and Pettable provide realistic ways to obtain an ESA letter through telehealth, and which option to go for really comes down to priorities between payment after approval and flat rates versus getting a more comprehensive plan for pets. No matter which route you decide on, ensure that you know the costs and any refund policies currently offered.

Ready to see how HealifyNow works? Book a free consultation or visit our ESA letter page to learn more.

Frequently Asked Questions (FAQs)