Hushmail vs Paubox
Updated October 16, 2026
Many small practices see Hushmail and Paubox as two versions of the same thing: HIPAA email with a business associate agreement. What most buyers miss is where the mail lives, since Hushmail gives a practice a separate secure inbox while Paubox encrypts the Gmail or Outlook account staff use every day. That choice shapes what patients see, how setup goes, and how the bill changes as a team grows.
Our analysts compared the two on price, patient experience, email fit, forms, and setup, using each vendor's public pricing page checked this month and the HIR review of each company. In the following sections, we compare them side by side, show which buyer each one suits, and list what each vendor has shipped recently.
Hushmail vs Paubox at a glance, October 2026
| What buyers weigh | Hushmail | Paubox |
|---|---|---|
| Published price per month (one user) | $11.99 per user per month on monthly billing for Healthcare Basic, or $11 per month billed yearly. Cheaper for one user | $42 per month on monthly billing for Standard, covering up to five senders, or $32 per month billed annually. |
| Cost for five senders | About $60 per month for five Healthcare Basic users on monthly billing. | $42 per month for Standard on monthly billing, since one plan covers up to five senders. Cheaper at five senders |
| Pricing model | Priced per user, in three healthcare tiers: Basic, Essentials, and Growth. | Priced by sender count, in three tiers: Standard, Plus, and Premium. |
| What drives cost | Number of users and the tier, which sets how many forms, e-signatures, and branding options a practice gets. | Number of senders and the tier, which adds inbound threat protection, archiving, and data loss prevention. |
| Patient experience | Patients may be sent to a private message center to read and reply. | Patients read the message in their normal inbox with no portal and no password. No portal |
| Gmail and Outlook fit | Staff send from Hushmail webmail or a custom domain set up in Hushmail. | Staff keep sending from Google Workspace or Microsoft 365, and each message is encrypted on the way out. Works in place |
| Intake forms and e-signatures | No forms on Basic, three forms on Essentials, and e-signatures from Growth up. Hushmail will build a form for $25. | Signable, encrypted forms come with every paid plan. Forms on every plan |
| Inbound threat protection | Not published | Spam, ransomware, and phishing protection on Plus and Premium. |
| Setup | A small practice can move patient email off consumer Gmail and publish its first forms in about two weeks. | Usually a change to how mail is routed, with complimentary setup help. Someone has to own the DNS settings. |
| Free trial | 14 days. | 14 days. |
| HIR overall score | 6.8, Conditional. | 7.5, Recommend. Higher score |
| Best for | Solo and small-group therapists, counselors, and psychologists who want HIPAA email and intake forms in one place. | Clinics, health plans, and digital health teams that send patient information from shared business mail. |
| Not a fit for | Teams that must keep their current Gmail or Outlook accounts, or that send high volumes of automated email from an EHR. | Buyers who only need patient texting or EHR portal messaging. |
Which fits which buyer
The right pick depends mostly on whether your staff can leave the email account they use now.
Choose Hushmail if
- You run a solo or small-group therapy practice and want the lowest price for one or two users.
- You want secure email, intake forms, and therapy questionnaires in one place.
- You are fine with some patients signing in to a message center to read replies.
- You are moving off a consumer Gmail account and can start fresh with a new inbox.
Choose Paubox if
- Your staff must keep sending from Google Workspace or Microsoft 365.
- You want patients to read messages in their own inbox with no portal or password.
- You have three or more senders, where one Paubox plan costs less than per-user seats.
- You also want inbound phishing protection, archiving, or data loss prevention from the same vendor.
What buyers say
In a therapist thread, one practitioner called Hushmail the cheapest and easiest option, with a BAA and a secure form feature that helps with intake. The same person rated Paubox nicer for anything sent to referral sources, because encryption happens automatically and recipients never log in to a portal.
Another therapist said they loved Hushmail for its lower price and good customer service. A health IT user said Paubox runs in the background with no buttons to click, and that patients simply get a normal email, which made the higher price worth it.
Verdict
Hushmail suits a solo or small-group therapy practice that wants one low-cost place for secure email and intake forms. Paubox suits a clinic or digital health team that wants staff to stay in Gmail or Outlook while patients read every message in their own inbox.
Skip Hushmail if your staff must stay in an existing Google Workspace or Microsoft 365 account. Skip Paubox if nobody can own the mail routing change. Skip both if what you need is patient texting or messaging inside an EHR portal.
Where the two tools are headed in 2027 and beyond
Hushmail: In October 2026 Hushmail made reusable message templates, with attachments and secure forms, available to all customers. In August 2026 it added a client referral form template, alongside insurance information and patient health questionnaire templates listed on its what's new page.
Paubox: Paubox added QR code scanning to its inbound security in January 2026 and launched a command line tool for sending HIPAA compliant email in May 2026, with forms support added days later. It added conditional logic to Paubox Forms in June 2026 and new data loss prevention features in September 2026 (sources 5 to 8).
So if you are choosing between them, count the people who send patient email and price both tools on that exact number.
Methodology
Prices come from the public pricing pages at hushmail.com and paubox.com, checked on October 16, 2026 in both monthly and annual billing views. The five-sender cost multiplies the Hushmail Basic monthly price by five and uses the Paubox Standard monthly price for up to five senders.
Scores, setup notes, and best-fit lines come from the HIR reviews of Hushmail and Paubox, scored under the HIR method. A green check marks a clear edge in the published data, and rows with nothing published for either vendor are left out.
Sources
- HIR review of Hushmail and HIR review of Paubox
- Hushmail pricing, checked October 16, 2026
- Paubox pricing, checked October 16, 2026
- What's new in Hushmail
- QR code scanning added to Paubox Inbound Email Security, January 9, 2026
- Introducing Paubox CLI, May 21, 2026, and forms support, May 24, 2026
- Conditional logic comes to Paubox Forms, June 18, 2026
- DLP Chat and DLP Observe and Report, September 17, 2026
- Reddit threads in r/therapists and r/healthIT, linked in the buyer section