Choose Headway if you have commercial insurance and want traditional, full-length sessions with an experienced private-practice therapist for just your copay. Choose Talkspace if you want messaging between sessions (with insurance, depending on your plan), integrated psychiatry, Original Medicare coverage, teen or couples therapy, or you are paying out of pocket.
Headway and Talkspace both let you use insurance for therapy, but they work in completely different ways. Headway is a directory of independent therapists who bill your insurance. Talkspace is a subscription platform if you pay out of pocket and bills per session with insurance, with its own network and psychiatry, plus messaging depending on your plan. Here is how to choose.
Side by side
| App | Best for | Price (annual) | Rating | Platforms |
|---|---|---|---|---|
| Headway | Private-practice therapists, copay only | Typically $20-$50/session | 8.2 | Web + in-person |
| Talkspace | Messaging, psychiatry, Medicare | $0 for most insured members, $15 average (per Talkspace), or $69-$109/wk | 8.4 | iOS, Android, Web |
How they work
Headway lists independent, licensed therapists and psychiatric prescribers who accept insurance. Headway says its network has more than 80,000 providers across all 50 states. You choose a provider, book, and pay your share after each session. There is no subscription and no platform fee. Therapy happens in scheduled sessions, by video or in person.
Talkspace is a subscription platform if you pay out of pocket; with insurance, you pay per session instead. You’re matched with a therapist and, depending on your plan, can message them between scheduled live sessions. It also offers psychiatry, teen therapy for ages 13 to 17, and couples therapy.
Cost with insurance
Headway: Headway says most clients pay $20 to $50 per session with insurance, compared with standard out-of-pocket rates of $100 to $300.
Talkspace: Talkspace says most insured members have a $0 copay and gives a $15 average; your copay depends on your plan.
With either, if you haven’t met your deductible, you may pay more until you do.
Winner: Talkspace, slightly, based on what each company says members typically pay.
Cost without insurance
Headway is built for insurance, and new clients need an active, accepted plan to sign up. If you already see a Headway provider and lose coverage, you may be able to switch to private pay at a rate your provider sets, if they offer it.
Talkspace costs $69 a week for messaging, $99 a week for live sessions plus messaging, or $109 a week with workshops.
Winner: Talkspace, since it is designed for out-of-pocket users as well as insured ones.
Insurance coverage, Medicare, and Medicaid
Headway works with major commercial insurers, select Medicare Advantage plans, and select Medicaid managed care plans, with availability that varies by plan and state. It does not handle out-of-network care. Since July 2026, your therapist must be credentialed in the state where you are when a telehealth session happens.
Talkspace accepts most major commercial plans, Medicare, and TRICARE. It does not accept Medicaid.
Winner: Talkspace for Original Medicare and TRICARE; Headway for Medicaid, where your state and plan are covered.
Sessions and support between them
Headway says most standard sessions run 45 to 60 minutes, by video or in person. There is no ongoing therapy by message.
Talkspace live sessions are 30 minutes on self-pay plans, and Talkspace does not publish insured session lengths. Self-pay plans with live sessions include messaging in between; with insurance, that depends on your plan.
Winner: Headway for depth in each session; Talkspace for contact between sessions.
Medication
Headway lists psychiatrists and nurse practitioners who bill your insurance, and some can prescribe controlled medications such as ADHD stimulants where state law allows.
Talkspace offers psychiatry for adults 18 and older at $299 for an evaluation and $175 per follow-up out of pocket, or your copay if your plan covers it. It does not prescribe controlled substances.
If you may need a controlled medication, confirm with any prescriber before booking. See our best brain training apps for ADHD guide for context on ADHD care.
Fees and fine print
Headway: cancellation fees are set by each provider and shown in your reminder emails, and Headway says it can’t waive them. You’re charged after each session, and you’ll need a payment method on file even if insurance covers everything.
Talkspace: self-pay plans renew automatically, so cancel before your renewal date if you’re stopping. With insurance, you pay per session rather than choosing one of these plans, and your plan decides which types of session are covered.
Which should you choose?
Choose Headway if you have commercial insurance, want an experienced therapist for full-length sessions, prefer in-person options, or may need a prescriber who handles controlled medications.
Choose Talkspace if you want to message your therapist between sessions, have Original Medicare or TRICARE, need teen or couples therapy through one platform, or are paying out of pocket.
Also consider: Alma, which works like Headway but adds sliding-scale options for out-of-network clients (most Alma therapists also offer a free 15-minute consultation), and Rula, which accepts Medicare everywhere and Medicaid in select states.
Common questions
Is Headway cheaper than Talkspace? Usually not, though your plan decides. Talkspace says most insured members have a $0 copay and gives a $15 average; most Headway clients pay $20 to $50.
Does Headway take Medicare? Only select Medicare Advantage plans. Talkspace accepts Medicare.
Does Talkspace take Medicaid? No. Headway accepts select Medicaid managed care plans in some states.
Which has longer sessions? Headway, which says most standard sessions run 45 to 60 minutes. Talkspace live sessions are 30 minutes on self-pay plans, and it does not publish insured session lengths.
Can I see a therapist in person? Often with Headway, depending on your area. Talkspace is online only.
The bottom line
Headway is the better choice for insured people who want a traditional, full-length therapy relationship with an experienced clinician. Talkspace is better if you value messaging, need Original Medicare or TRICARE coverage, want teen or couples options, or are paying out of pocket.
For more, see our Headway review, Talkspace review, and best online therapy that takes insurance.
One important note: if you are in crisis or considering harming yourself, please reach out now. In the US, call or text 988 for the Suicide & Crisis Lifeline. Immediate human support is available.