HIPAA & BAA · Transactional email
Is Twilio SendGrid HIPAA compliant?
No. Twilio will not sign a BAA for SendGrid, and SendGrid is not a HIPAA-eligible service, so it must not be used with PHI.
Key facts
- BAA available: No — vendor will not sign a BAA
- Official source: Twilio SendGrid Docs — Is SendGrid HIPAA Compliant? — https://www.twilio.com/docs/sendgrid/ui/account-and-settings/hipaa-compliant (verified 2026-06)
What to do instead of Twilio SendGrid
- Do not send any PHI through SendGrid; it offers no transmission security beyond standard SMTP.
- For HIPAA-eligible messaging, use Twilio's other products (e.g., Programmable Messaging) that ARE covered, by executing Twilio's Business Associate Addendum.
- Alternatively use a purpose-built HIPAA-compliant email vendor such as Paubox or LuxSci.
- Keep transactional emails that contain PHI on a BAA-covered channel and route only non-PHI mail through SendGrid.
Important caveats
- Twilio's BAA for its core platform explicitly does NOT extend to SendGrid.
- SendGrid itself states it is not a HIPAA Eligible Service.
- Even appointment or billing emails can contain PHI; verify content before using any non-covered channel.
The bottom line
No software is "HIPAA compliant" on its own. HIPAA compliance is a property of your organization, not a tool. Even with a signed BAA, you remain responsible for configuring Twilio SendGrid correctly, limiting access to PHI, training staff, and maintaining your own safeguards. This page is general information, not legal advice; confirm current terms with Twilio SendGrid.
Frequently asked questions
Does Twilio SendGrid sign a BAA?
No. Twilio SendGrid does not sign a Business Associate Agreement, so it should not be used to create, receive, store, or transmit protected health information (PHI).
Is Twilio SendGrid HIPAA compliant out of the box?
No software is "HIPAA compliant" by itself. Even when Twilio SendGrid offers a BAA, you are responsible for signing it, configuring the product correctly, restricting access, and maintaining your own administrative, physical, and technical safeguards.
What should I check before using Twilio SendGrid with PHI?
Twilio's BAA for its core platform explicitly does NOT extend to SendGrid.
