Choose Talkspace if you want to message your therapist between sessions, a low copay (Talkspace says most insured members have a $0 copay), TRICARE coverage in both the East and West regions, or therapy for a teen. Choose Rula if you want full hour-long sessions, broad insurance coverage, Medicaid in select states, or in-person options.
Rula and Talkspace are the two strongest picks for people who want to use insurance for online therapy, and both offer medication management. They just deliver care in very different ways.
| App | Best for | Price (annual) | Rating | Platforms |
|---|---|---|---|---|
| Rula | Hour-long sessions, broad coverage | ~$15 avg copay or $150/session | 8.4 | iOS, Android, Web |
| Talkspace | Messaging, low copays | $0 for most insured members (per Talkspace) or $69-$109/wk | 8.4 | iOS, Android, Web |
Cost with insurance
Talkspace says most insured members have a $0 copay; your copay depends on your plan.
Rula says patients pay about $15 per session on average.
Either way, if you haven’t met your deductible, you may pay more early in the year.
Winner: Talkspace, going by what each company reports, though your own plan decides.
Cost without insurance
Talkspace is a weekly subscription: $69 for messaging, $99 with live sessions, or $109 with workshops.
Rula charges $150 per session, or $165 for couples and family therapy.
Winner: Talkspace, which is built for out-of-pocket users as well as insured ones.
Insurance coverage
Rula is in-network with more than 100 commercial plans, accepts Medicare in all 50 states, accepts Medicaid in select states, and takes TRICARE West only.
Talkspace accepts most major plans, Medicare, and TRICARE in both the East and West regions, but not Medicaid.
Winner: Rula for breadth and Medicaid; Talkspace for TRICARE, since it covers both regions and Rula covers only the West.
How sessions work
Rula uses scheduled, hour-long sessions by video, with in-person options in some areas. There’s no ongoing messaging between sessions.
Talkspace pairs live sessions, typically 30 minutes, with messaging between them on most plans.
Winner: Rula for depth in each session; Talkspace for support between sessions.
Medication
Both offer psychiatry alongside therapy. Without insurance, Rula charges $225 for an intake and $175 per follow-up; Talkspace charges $299 for an evaluation and $175 per follow-up. With insurance, both usually cost your copay.
Winner: Rula, on out-of-pocket price.
Fine print
Rula charges $99 if you cancel a therapy session within 24 hours or miss it, and automatically books four follow-ups after your first appointment, so cancel any you don’t want in advance.
Talkspace plans renew automatically, so cancel before your renewal date if you’re stopping.
Who each one suits
Choose Talkspace if you like writing to your therapist between sessions, have TRICARE (especially in the East Region, which Rula does not cover), need therapy for a teen aged 13 to 17, or are paying out of pocket.
Choose Rula if you want traditional hour-long sessions, have Medicaid in a state Rula covers, want in-person options, or your plan isn’t accepted by Talkspace.
Common questions
Is Rula cheaper than Talkspace? With insurance, usually not: Rula says patients pay about $15 a session on average, while Talkspace says most insured members have a $0 copay. Your own plan decides. Without insurance, Talkspace usually costs less.
Do both accept Medicare? Yes. Rula accepts it in all 50 states, and Talkspace accepts it too.
Does either accept Medicaid? Rula does, in select states. Talkspace doesn’t.
Do both accept TRICARE? Talkspace takes TRICARE East and West. Rula takes TRICARE West only.
Which has longer sessions? Rula, with hour-long sessions. Talkspace live sessions are usually 30 minutes.
Can I message my therapist? On Talkspace, yes. On Rula, care happens in scheduled sessions.
The bottom line
Both are excellent ways to use insurance for therapy. Talkspace is the better choice for messaging, out-of-pocket flexibility, TRICARE in either region, and teens. Rula is better for longer sessions, broad coverage, and Medicaid. For more, see our Rula review, Rula cost guide, Talkspace review, and Rula vs BetterHelp.
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.