Moving off Hushmail: the HIPAA compliant email to pick next
Seven destinations, one per reason to leave, and a seven-step migration that keeps your BAA in place.
The short answer: Google Workspace if you want one inbox your patients already know and a BAA you accept in a few clicks; Paubox if you want patients to read encrypted email with no link and no password; Proton if privacy beats convenience; Microsoft 365 if your practice runs on Outlook; Spruce if you'd rather move patient conversations into an app; LuxSci for high volume and Virtru to keep control after you hit send. One thing to know first: Hushmail supports IMAP, so your messages can come with you. Your intake forms can't; you rebuild them. We compared all seven and reread their official pages in 2026.
The ranking is editorial: a sponsored spot is always labeled on its card, and no affiliate link changes a score.
Why practices end up leaving Hushmail
Hushmail has loyal users. Plenty of therapists have run it for years and like its encrypted intake forms. People rarely leave over security. They leave over what the patient goes through, per-account pricing, and a mailbox that sits apart from everything else. Six reasons, each checked against the vendor's pages or user reviews in 2026.
Patients have to click a link and remember a password
An encrypted Hushmail message lands as a "Read your secure message" link. The recipient signs in with a Google, Microsoft or Apple account, or creates a password. If they forget it, Hushmail can't recover it, and after a reset their older messages are gone unless you resend them. Therapists put it bluntly: most "HIPAA compliant" emails annoy clients because of that special link.
Only the Healthcare plans come with a BAA
Hushmail's plan table is explicit: Healthcare Basic, Essentials and Growth include a BAA; Small Business, Law and Personal don't. A practice that picked the small business plan because it looked the same has no BAA at all. If that's you, switch plans or switch tools now.
A second inbox next to the one you actually use
Hushmail for Healthcare is its own mailbox. If your team already works in Gmail or Outlook, you juggle two inboxes, two address books and two logins. That's the reason that sends most practices to Paubox, which encrypts from the inbox you already have. Hushmail does sell a "for Professionals" option that keeps your everyday email, but it's still one more product beside your inbox.
Per-account pricing that climbs once you need forms
Healthcare Basic costs $11.99 a month billed monthly, or $131.89 a year, for one user, with no forms. Forms start with Essentials at $14.99 a month; Growth is $17.99. Hushmail also charges $25 per form if its team builds it for you. Fair for a solo clinician; a duplicate subscription for a practice already paying for Google Workspace.
Phone access and account recovery
Negative reviews keep circling the same points: no app people find handy, a site that's hard to use on a phone, and a locked account that's hard to get back. They're a minority (the average rating is good), but for a clinician answering between sessions, they're the ones that hurt.
It's built for one patient at a time
Hushmail is made for one-to-one messages and forms. Appointment reminders to your whole panel, lab result notices or a newsletter to patients need a bulk sending tool with its own BAA. Growing clinics hit that wall first.
You're leaving because… go to…
The right Hushmail alternative depends on what's pushing you out. Usually one line fits; each card links to the full profile below.
BAA accepted by an admin in the console, from $7 per user.
Patients can't find the link or forget the passwordPauboxPatients read encrypted email in their normal inbox, no portal.
Privacy comes before convenienceProtonZero-access encryption and a BAA offered to every user.
Your practice already runs on OutlookMicrosoft 365BAA included by default in the data protection terms.
You'd rather replace email with patient messagingSpruceSecure app-based messaging, BAA included automatically.
You send in bulk or want to pull back sent mailLuxSci or VirtruLuxSci for volume, Virtru to revoke a sent message.
Hushmail alternatives, tool by tool
For each one: why move there, who it fits, its limit, how to migrate from Hushmail, and what it costs. Prices are what each vendor lists in 2026.
Google Workspace: one inbox, a BAA in a few clicks
Default pickWhy move here. Your patients know Gmail and so does your staff. A super admin accepts the BAA right in the Admin console (account settings, legal and compliance), no sales call needed. You drop the second inbox: calendar, docs and email live together.
Who it fits. Practices of two to fifty people that want familiar email inside a clean HIPAA setup.
Who it doesn't. Anyone who wants every message encrypted to the patient with zero setup: Gmail encrypts the connection, not the message itself.
Its limit. The BAA covers only services on Google's HIPAA Included Functionality list, and third-party Marketplace add-ons are out. Many practices add Paubox on top to encrypt without a portal. Business Starter is $7 per user per month on an annual plan, Business Standard $14.
How to migrate. The data migration tool in the Admin console pulls from an IMAP mailbox: enter Hushmail's IMAP server and each account's credentials, and Google copies the folders. Run it a week early, then a second pass on cutover day.
- BAA
- accepted in the console
- Price
- Business Starter $7/user
- Best for
- teams already on Gmail
- Limit
- add-ons outside the BAA
Paubox: patients read in their own inbox, no link, no password
No portalWhy move here. It's the direct fix for the top Hushmail complaint. Paubox encrypts email sent from Google Workspace or Microsoft 365, and patients read it in the inbox they already use. You keep your email and add the compliance layer.
Who it fits. Practices on Gmail or Outlook that send health information to patients often.
Who it doesn't. Solo clinicians: all three plans start at five senders, so you pay for five seats even alone.
Its limit. Price. Email Suite Standard is $32 a month billed annually ($42 monthly) for one to five senders; archiving and data loss prevention only come with Premium at $75. Paubox doesn't host your mailbox, so you still need Google Workspace or Microsoft 365.
How to migrate. Move your Hushmail mailboxes to Google Workspace or Microsoft 365 first, then connect Paubox. Every plan includes a BAA at no extra cost, and the trial runs 14 days: use it to send a test message to a willing patient.
- BAA
- included, no extra cost
- Price
- Standard $32/mo, 5 senders
- Best for
- practices on Gmail or Outlook
- Limit
- 5-sender minimum
Proton: privacy first, with a BAA for everyone
Strictest encryptionWhy move here. If you chose Hushmail for privacy, Proton goes further: end-to-end and zero-access encryption, so the vendor can't read your mail. Proton offers a BAA to every user; request it at privacy@support.proton.me with the subject "HIPAA BAA".
Who it fits. Clinicians and small teams who put confidentiality ahead of patient convenience.
Who it doesn't. Anyone writing mostly to patients on Gmail: to an outside address, a message is only end-to-end encrypted if you set a password. You're back to the link-and-code routine.
Its limit. The BAA isn't automatic; you have to ask. Mail Essentials is $6.99 per user per month billed annually, Workspace Standard $12.99.
How to migrate. Proton's import tool connects to an IMAP mailbox: point it at Hushmail's IMAP server. Go account by account and compare folder counts before you cut over.
- BAA
- on request, for all
- Price
- Mail Essentials $6.99/mo
- Best for
- privacy above all
- Limit
- password for outside mail
Microsoft 365: the BAA is already in your contract
For Outlook shopsWhy move here. Microsoft's BAA is available by default through its Data Protection Addendum to every customer that is a covered entity or business associate. Exchange Online is in scope. If you already live in Word and Excel, everything ends up in one place.
Who it fits. Practices and clinics that run on Outlook and Teams.
Who it doesn't. Anyone hoping for compliance with no setup: Microsoft states its services don't on their own achieve HIPAA compliance.
Its limit. Encrypting mail to outside recipients takes configuration and depends on the plan, and patients often get a one-time code. Business Basic starts at $7 per user per month billed annually, Business Standard $14.
How to migrate. Exchange Online's IMAP migration imports Hushmail mailboxes from a file listing each account. Contacts and calendars don't travel over IMAP; export them separately.
- BAA
- included by default
- Price
- Business Basic $7/user
- Best for
- Outlook practices
- Limit
- encryption needs setup
Spruce: swap email for patient messaging
Patient messagingWhy move here. If patients hate encrypted links, maybe stop emailing them. Spruce is a communication platform for clinicians with secure app-based messaging. A BAA comes automatically with trials and paid plans.
Who it fits. Clinicians who trade lots of messages with patients between visits and want it all in one place.
Who it doesn't. Anyone who needs a real mailbox to write to labs, insurers or other providers.
Its limit. Per-user pricing: Basic is $24 a month, Communicator $49, before taxes. And patients have to adopt the app.
How to migrate. Nothing to import. Keep Hushmail while patients move to the app, then shrink it to an archive account.
- BAA
- included automatically
- Price
- Basic $24/user/mo
- Best for
- frequent patient messages
- Limit
- not an email inbox
LuxSci: when you send a lot of health email
High volumeWhy move here. Hushmail is built to write to one patient at a time. If you send reminders, results or newsletters to thousands, LuxSci has dedicated products, each with a BAA included.
Who it fits. Clinics, labs and health tech vendors sending at volume.
Who it doesn't. Solo clinicians, who'd pay for capacity they'll never use.
Its limit. Monthly prices that stack by product: Secure Gateway $50 a month for up to five users, High Volume $99 for up to 9,999 emails a month, Marketing $129 for up to 4,999 contacts. Reviewers call the interface dated.
How to migrate. Keep your everyday email on Google or Microsoft and plug LuxSci in for bulk sends. Export your Hushmail contact lists to CSV before you leave.
- BAA
- included
- Price
- Secure Gateway $50/mo
- Best for
- bulk sending
- Limit
- priced per product
Virtru: stay in control after you hit send
Control after sendingWhy move here. Virtru encrypts email and attachments from Gmail or Outlook and lets you revoke or expire a message after it's sent. A signed BAA comes with the Starter plan.
Who it fits. Teams sharing sensitive documents with partners who want the option to pull them back.
Who it doesn't. Small practices: Starter is $119 a month billed annually, with five users included.
Its limit. The entry price, and recipients without an account who sometimes struggle to open messages. Business is $219 a month.
How to migrate. Same as Paubox: move Hushmail mailboxes to Google Workspace or Microsoft 365, then install Virtru.
- BAA
- signed from Starter
- Price
- Starter $119/mo, 5 users
- Best for
- revocable documents
- Limit
- pricey for small practices
The 7 alternatives side by side
Our default: Google Workspace for a team, with Paubox on top if patients stall on encrypted links. For a solo clinician, Hushmail Basic ($11.99 a month) still costs less than Paubox ($32 a month for five seats); switching only saves money if you drop a duplicate inbox. One row per tool: BAA and encryption on the left, entry price and migration path on the right.
| BAA and encryption | Entry price and migration | |
|---|---|---|
| HushmailStarting point | BAA on Healthcare plans only; link and password for patients | Healthcare Basic $11.99/mo, no forms; leave via IMAP |
| Google WorkspaceTeams | BAA accepted in the console; connection encrypted, not the message | Business Starter $7/user, annual; IMAP import from the console |
| PauboxNo portal | BAA included; patients read in their inbox | Standard $32/mo annual, 1 to 5 senders; added to Google or Microsoft |
| ProtonPrivacy | BAA on request; password for outside mail | Mail Essentials $6.99/user, annual; IMAP import |
| Microsoft 365Outlook | BAA by default; encryption to configure | Business Basic $7/user, annual; Exchange IMAP migration |
| SprucePatient messaging | BAA included automatically; in-app messaging | Basic $24/user/mo; nothing to import |
| LuxSciVolume | BAA included; bulk sending | Secure Gateway $50/mo up to 5 users |
| VirtruRevocation | Signed BAA from Starter; revoke messages | Starter $119/mo annual, 5 users |
Entry prices before tax, subject to change. Always price your real number of accounts.
Moving off Hushmail in seven steps
Order matters. Each step protects something: your messages, your forms, your BAA or your patients.
Sign the new BAA before the first message
Day 1No PHI should touch the new email until the BAA is in place: accepted in the console at Google, requested by email at Proton, included by default at Microsoft. Keep a dated copy in your compliance records.
- Time
- minutes to a few days
- Risk if rushed
- PHI without a BAA
List everything that lives in Hushmail
Day 1Write down every account, alias and form (with its questions and e-signature) and everywhere your address appears: website, directory listings, signature, printed paperwork. Forms don't migrate, so screenshot each one and list its fields.
- Time
- an hour
- Risk if rushed
- a forgotten form
Rebuild forms before cutting over
Week 1Recreate intake and consent forms in the destination or your EHR, and confirm they sit under a BAA. Swap the links on your site the same day, then submit a test form.
- Time
- half a day
- Risk if rushed
- lost patient requests
Copy mail over IMAP, twice
Week 1Hushmail recommends IMAP, which reaches every folder; POP only gets the inbox. Run a first copy to the destination, then a second on cutover day for the latest mail. Compare message counts folder by folder.
- Tool
- destination's IMAP import
- Risk if rushed
- missing folders
Save the compliance archive
Week 1Hushmail's archive keeps a copy of every email sent or received, but the vendor doesn't publish what happens to it after you cancel. Download it locally through an IMAP client before closing anything, and store it under your retention policy.
- Gain
- proof kept for audits
Move your domain and tell patients
Cutover dayOn your own domain, change the MX records and set SPF, DKIM and DMARC for the new provider. Then send patients a short note: how they'll read your email now, nothing to install with Paubox, an app with Spruce.
- Time
- an hour plus DNS propagation
- Risk if rushed
- bounced email
Keep Hushmail a month, then cancel
Month 1Keep one Hushmail account active while the last patients reply to old links: replies to an encrypted message come back through Hushmail. Cancel only once nothing arrives there and your archive export checks out.
- Cost
- one month of subscription
- Risk if rushed
- lost patient replies
Is your tool missing from this page? Email us: hello@hackceleration.com
What makes a Hushmail exit go wrong
The same mistakes show up again and again. None is technical: they're oversights, and each costs more than the time it would have taken to avoid it.
Sending before the BAA is signed
The worst one. One lab result sent from Gmail before the BAA is accepted and you're outside HIPAA. BAA first, migration second.
Assuming the new provider encrypts on its own
Google and Microsoft sign a BAA, but they don't encrypt each message to the patient without setup. Microsoft says so plainly: its services don't on their own achieve compliance. Have the encryption layer ready (Paubox, Virtru, Microsoft's encryption) before you drop Hushmail.
Forgetting replies to old links
A patient replying to an old encrypted message replies through Hushmail. Cancel too early and that reply vanishes without you knowing.
Losing the archive
Your Hushmail archive is your proof. Export it before you cancel, since nothing published guarantees access afterward.
Adding add-ons the BAA doesn't cover
At Google, third-party Marketplace add-ons aren't covered. A signature or CRM add-on wired into Gmail can carry PHI outside the agreement.
Comparing prices without counting seats
Paubox and Virtru bill a five-seat minimum, Hushmail bills per account. Run the math on your real headcount. Our ranking of HIPAA compliant email lists prices for one and five users, and our page for therapists covers the solo case.
- New BAA signed and filed
- Accounts, aliases and forms listed
- Forms rebuilt, with a test submission
- First IMAP copy done and counted
- Hushmail archive exported locally
- MX, SPF, DKIM and DMARC set
- Patients told how to read your email now
- Hushmail kept a month before canceling
Hushmail alternatives: frequently asked questions
What is the best HIPAA compliant email for therapists leaving Hushmail?
Google Workspace with the BAA accepted, plus Paubox if clients stall on encrypted links. Solo with few sensitive messages, Hushmail Basic is often still the cheapest. Our therapist ranking runs the numbers.
Is Gmail HIPAA compliant?
Free Gmail isn't: there's no BAA. Gmail inside Google Workspace can be, once an admin accepts the BAA in the console and access is locked down. Third-party add-ons stay outside the BAA.
Is Proton Mail a good Hushmail alternative?
Yes for privacy: zero-access encryption and a BAA offered to everyone. Less so for patients: to a Gmail address, a message is only end-to-end encrypted with a password, just like Hushmail.
Can I export my Hushmail email?
Yes, over IMAP: a client like Thunderbird or the destination's import tool pulls every folder. POP only takes the inbox. Forms don't export like email; rebuild them.
Is Hushmail's Small Business plan enough for healthcare?
No. The plan table shows a BAA on the three Healthcare plans and none on Small Business, Law or Personal. Without a BAA, it isn't a HIPAA setup.
What happens to encrypted messages I already sent?
They stay in Hushmail. Patients read them with their link and password as long as your account exists. Keep one account open for the last replies, then export the archive.
How much does a Hushmail alternative cost for five people?
Five Google Workspace Business Starter seats come to $35 a month on an annual plan. Paubox Standard is $32 a month billed annually for one to five senders, on top of your email. Virtru Starter is $119 a month for five users.
Do I need a new BAA if I switch to Google Workspace or Microsoft 365?
Yes. A BAA is signed with each vendor that handles PHI. Accept Google's in the Admin console; Microsoft's comes through its data protection terms. Our guides to leaving Google Workspace and leaving Microsoft 365 cover the other direction.
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