A Y Combinator-backed telemedicine startup announced Tuesday it has begun offering Medicaid-reimbursed addiction treatment in Pennsylvania and Michigan, targeting the 37,500 patients on its waitlist. Sunflower Clinic pairs licensed therapists and psychiatrist-prescribed medication with an AI chatbot the company says has logged more than 7 million messages since its launch.
The San Francisco-based company says it has secured substance use disorder facility licensing and state Medicaid approval in both states. That allows patients to access weekly video therapy, round-the-clock messaging, and medications including naltrexone for alcohol use disorder starting at $89 per month, according to the company's announcement on Launch YC.
Sunflower built its clinic infrastructure atop a consumer sobriety app that the company claims has powered 21.5 million days of sobriety. Founder and CEO Koby Conrad said that nearly 80% of surveyed users at the 60-day mark report the app prevented at least one relapse, and 93.6% report reduced substance use. The company has not published peer-reviewed outcome studies.
The clinic treats dependencies ranging from alcohol and opioids to stimulants, cannabis, and behavioral addictions such as gambling and gaming. Patients schedule appointments through the clinic's web portal and meet with licensed professional counselors. Medical director Daniel Montville, MD, completed his psychiatry residency at Mayo Clinic, where he served as chief resident. Senior psychiatrist Glen Rebman, DO, and behavioral health medical director Raphael Golebiowski, MD, who interned at Mayo, round out the clinical leadership team listed on the site.
Scaling State by State
"We're building a 50 state telemedicine program for SUDs, reimbursed by medicaid," Conrad wrote in the launch post. The company obtained a National Provider Identifier number for Sunflower Clinic, P.A., with the clinic's legal entity operating from Royal Oak, Michigan, according to its terms of service.
Sunflower uses the Healthie telehealth platform for video sessions and messaging, according to consent forms. For medication, the clinic partners with Precision Compounding Pharmacy in Bellmore, New York, to fulfill compounded naltrexone tablets combining 45 mg naltrexone with 5 mg vitamin B6.
"Naltrexone gives you room to think. Therapy is what you do with that room," a clinic director wrote on the program's informational page.
Entering a Competitive Arena
Sunflower faces established players in the telemedicine substance use disorder market. Ophelia accepts many Medicaid and Medicare plans across multiple states. Workit Health operates in-network with commercial and some Medicaid plans. Boulder Care and Bicycle Health offer tele-MAT focused heavily on opioid use disorder, while Pelago and Quit Genius sell SUD programs to employers.
Pennsylvania recently cleared the path for Sunflower's model when the state Department of Drug and Alcohol Programs issued telehealth treatment licensing exceptions, expanding virtual SUD treatment statewide. Michigan has also revised its SUD administrative rules, eliminating outpatient as a standalone licensed category, according to state records.
Funding and Growth Plans
Conrad raised more than $3.88 million from Flybridge, Y Combinator, and a16z Speedrun as of November 2025, he wrote on LinkedIn. Before founding Sunflower, Conrad led growth at Rupa Health, scaling the company from $5 million to $75 million in annual revenue, according to his YC bio. The startup now employs 15 people, per Y Combinator's company profile.
Sunflower said it plans to expand beyond Pennsylvania and Michigan soon. The company describes a total addressable market of $153 million among its waitlist population, though that figure appears to reflect anticipated revenue rather than patients served. The clinic's homepage lists substances from alcohol and fentanyl to behavioral conditions including sex addiction and self-harm.
The move into Medicaid reimbursement marks a significant shift for Sunflower, transforming what began as a free consumer app into what the company reports is a licensed medical facility navigating the complex intersection of telehealth regulations, addiction treatment protocols, and state-by-state insurance frameworks. Whether the company can replicate its initial traction across 50 states remains an open question, particularly as regulatory environments and reimbursement structures vary widely.
