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Is Twilio HIPAA compliant? (2025 update)

Written by Caitlin Anthoney | May 8, 2025 12:04:35 AM

Based on our research, Twilio may be HIPAA compliant, but only for certain products and only when specific conditions are met according to the requirements set by the U.S. Department of Health and Human Services (HHS) to safeguard protected health information (PHI).

 

What is Twilio?

Twilio is a cloud communications platform that allows developers to integrate voice, messaging, video, and other communication functions into their applications using APIs. It is commonly used by businesses to send SMS alerts, support customer calls, and expand telehealth capabilities. While Twilio offers HIPAA compliance for some of its services, customers must take additional steps to meet HIPAA requirements.

 

Will Twilio sign a business associate agreement (BAA)?

Yes, Twilio will sign a business associate agreement, which it calls a Business Associate Addendum.

 

What does the Twilio BAA cover?

Twilio’s BAA applies only to specific services and emphasizes that HIPAA compliance is a shared responsibility between Twilio and the customer. Twilio outlines its BAA coverage here, noting that customers must be on the Enterprise Edition and implement appropriate safeguards.

Their BAA covers:

  • Programmable SMS
  • Programmable Voice
  • Programmable Video
  • SIP
  • Runtime tools
  • Support for U.S. State Privacy Laws including CCPA, VCDPA, CPA, CTDPA, and UCPA
  • Restrictions on Twilio’s use of customer content for business purposes
  • Customer notifications regarding compliance concerns
  • Certification of CCPA understanding and obligations

Twilio explains:

“Twilio’s BAA has been developed taking into account the specific products and services that Twilio offers and considers HIPAA compliance as a shared responsibility between the customer and Twilio.”

 

Is Twilio HIPAA compliant?

Twilio may be HIPAA compliant, but only when used with eligible services, the customer signs a BAA, and all compliance requirements are followed. Twilio’s approach views HIPAA compliance as a shared responsibility, not something provided automatically.

 

The HIPAA compliant solution: Paubox 

Paubox has developed a HIPAA compliant email and texting solution that makes it easier for providers to connect with their patients. It eliminates the need for third-party apps or logins, allowing patients to receive secure, encrypted texts and emails directly on their phones. 

Learn more: HIPAA Compliant Email: The Definitive Guide

 

FAQs

What is HIPAA?

The Health Insurance Portability and Accountability Act (HIPAA) sets national standards for protecting the privacy and security of certain health information, known as protected health information (PHI).

HIPAA is designed to protect the privacy and security of individuals’ health information and to ensure that healthcare providers and insurers can securely exchange electronic health information. Violations of HIPAA can result in significant fines and penalties for covered entities.

 

Who does HIPAA apply to?

HIPAA applies to covered entities, which include healthcare providers, health plans, and healthcare clearinghouses. It also applies to business associates of these covered entities. These are entities that perform certain functions or activities on behalf of the covered entity.

 

What is a business associate agreement?

A business associate agreement (BAA) is a legally binding contract establishing a relationship between a covered entity under the Health Insurance Portability and Accountability Act (HIPAA) and its business associates. The purpose of this agreement is to ensure the proper protection of personal health information (PHI) as required by HIPAA regulations.