Last verified: October 2026, against Microsoft Learn and Microsoft's HIPAA compliance documentation. General information, not legal advice — confirm with your compliance officer or attorney.
Is Copilot HIPAA compliant? The Copilot built into a practice's business Microsoft 365 subscription is covered by Microsoft's business associate agreement (BAA). The free Copilot app on someone's personal Microsoft account is not. The bigger risk on a covered setup isn't Microsoft at all: it is how widely patient files are already shared inside your own tenant.
Short answer (dated) from Microsoft's compliance documentation
Short answer (verified October 2026): Microsoft's HIPAA compliance page (opens in a new tab) lists Microsoft Copilot and Microsoft Copilot Chat among the in-scope Office 365 commercial services, and says its HIPAA BAA "is available through the Microsoft Online Services Data Protection Addendum by default" to covered entities and business associates. Microsoft's enterprise data protection page (opens in a new tab) adds that both "support HIPAA compliance for properly configured implementations," and that web search queries "aren't covered by the DPA and Business Associate Agreement."
Microsoft also answers the question practices most want answered: does a BAA make you compliant? "No. … using Microsoft services doesn't on its own achieve HIPAA compliance."
Microsoft 365 Copilot, Copilot Chat and the consumer app
Microsoft has renamed its business products: Microsoft 365 Copilot is now Microsoft Copilot, and Microsoft 365 Copilot Chat is now Microsoft Copilot Chat. Older licenses and menus may still use the old names.
| Product | Who gets it | Reaches your mail and files? | Under the BAA? |
|---|---|---|---|
| Microsoft Copilot (paid license) | Business users | Yes, through Microsoft Graph | Yes |
| Microsoft Copilot Chat | Business users signed in with a work account | Web by default; Outlook mail and calendar when used in Outlook | Yes |
| Consumer Copilot app | Anyone with a personal Microsoft account | No access to your tenant | No |
Copilot Chat shows a green shield when enterprise data protection (opens in a new tab) applies, and Microsoft Support says that protection comes from signing in with a work or school account (Microsoft Support (opens in a new tab)). The consumer app on a personal account sits outside your organization's agreement. Tell staff to look for the shield.
One wrinkle: Microsoft now lets people with a personal Microsoft 365 Personal, Family or Premium subscription use Copilot on work files. Microsoft says enterprise protections still apply to the organization's files, and admins can switch the option off through cloud policy (Microsoft Support (opens in a new tab)).
How Microsoft's BAA works for Microsoft 365
Unlike most vendors, Microsoft doesn't make you request a BAA. It is built into the Data Protection Addendum (DPA) for covered entities on commercial subscriptions. The in-scope list also covers Exchange Online, Teams, OneDrive for Business, SharePoint Online and Forms.
Three caveats the BAA doesn't fix:
- Web search. Copilot sends short search queries to Bing. Microsoft says these are not covered by the DPA or BAA. Prompts that name a patient shouldn't trigger web search.
- Anthropic models. Microsoft runs Claude models inside Copilot as a subprocessor under its Product Terms and DPA, on by default for most commercial tenants outside the EU, EFTA and UK. Models labeled "Anthropic models with Data Retention" are different: Microsoft says that data "is stored by Anthropic and not subject to" the Product Terms and DPA (Anthropic models in Microsoft Online Services (opens in a new tab)). They are off by default; keep them off for anyone handling PHI.
- Agents and connectors. Microsoft tells admins to check each agent's own privacy terms.
Teams has its own HIPAA questions; see Microsoft Teams and HIPAA.
This is general information, not legal advice. Confirm how it applies to your practice with a qualified advisor.
Permissions hygiene before you turn Copilot on
Microsoft's deployment blueprint (opens in a new tab) starts with "remediate oversharing" and notes that SharePoint Advanced Management is included with a Copilot license. For a small practice, that translates to:
- Inventory where PHI lives. List the SharePoint sites, OneDrive folders and mailboxes that hold patient information.
- Fix broad sharing. Replace organization-wide links with named people or groups.
- Prune Teams channels, including shared channels with outside billing companies.
- Apply sensitivity labels to folders that hold PHI. Microsoft says Copilot honors the usage rights those labels grant.
- Set retention for Copilot interactions in Microsoft Purview, matched to your records policy.
- Pilot with a small group before licensing everyone.
This is the minimum necessary standard in practice: each role should see only the PHI its job needs (HHS (opens in a new tab)).
Safe uses for a practice
| Use | Verdict |
|---|---|
| Drafting a staff memo about holiday hours | Safe on a work account |
| Summarizing a public CDC guideline for a team huddle | Safe on a work account |
| Summarizing a patient email thread on a covered work account | Allowed for authorized staff; review before replying |
| The same summary in the consumer app on a personal account | Unsafe |
| Asking Copilot to "find every file mentioning [patient name]" | Allowed only for staff whose role needs it |
For the public side of your practice, such as tracking scripts on your website, a free marketing audit flags privacy risks such as pixels on patient forms. Medfy keeps website form and chat data in separate, encrypted regional databases under the practice's BAA; see Medfy's HIPAA safeguards. For other assistants, compare Gemini and HIPAA, ChatGPT and HIPAA and the HIPAA-compliant AI overview.
Frequently asked questions
Is Microsoft 365 Copilot covered by Microsoft's BAA?
Yes, as of October 2026. Microsoft lists Microsoft Copilot, the new name for Microsoft 365 Copilot, and Microsoft Copilot Chat as in-scope services for its HIPAA BAA, which it offers through the Data Protection Addendum. Microsoft says they support HIPAA for properly configured implementations, and web searches sent to Bing are not covered. Confirm your configuration with your compliance officer or attorney.
Can Copilot see patient emails in Outlook?
Yes, if the person using it can. Copilot surfaces only data the signed-in user already has permission to view, and Copilot Chat in Outlook can read that user's email, calendar and chats. A receptionist who can open the shared patient inbox can ask Copilot to summarize it. That is acceptable under a BAA for authorized staff, which is why mailbox permissions matter.
Is the free Copilot app safe for practice work?
Not for anything involving patients. Microsoft's enterprise protections and BAA apply to Copilot used by an organization, signed in with a work or school account. The consumer app on a personal Microsoft account sits outside your organization's agreement. Use it, if at all, for public information only, and consider blocking personal accounts on practice computers. Check the decision with your compliance officer.
What should we check before enabling Copilot?
Five things. Confirm your Microsoft 365 tenant is a commercial subscription covered by the BAA. Review SharePoint and OneDrive sharing links and who can open them. Prune Teams channel membership. Keep Anthropic models with Data Retention switched off. Then train staff on what Copilot can reach and what still needs a second look before it goes to a patient.