CompyMax

Is Microsoft Copilot HIPAA compliant?

Only under specific conditions

Yes for Microsoft 365 Copilot and Copilot Chat used under a commercial Microsoft 365 licence, where the agreement already applies, but the consumer Copilot signed into with a personal account is a different product and is not named in scope.

Applies to Microsoft 365 Copilot and Microsoft 365 Copilot Chat. Last reviewed .

Researched and maintained by the CompyMax editorial team to our published standards.

What you must do

  • Use Microsoft 365 Copilot or Microsoft 365 Copilot Chat under a commercial Office 365 or Microsoft 365 licence. Microsoft names both in its in-scope service list for Office 365 Commercial and for the Government Community Cloud.
  • Nothing separate to sign: the agreement arrives through the Product Terms and Data Protection Addendum, the same route as the rest of the tenant.
  • Have staff sign in with the organisational account. A personal Microsoft account puts the session outside the in-scope service entirely.
  • Treat prompts as disclosures. What a staff member pastes into Copilot is a use of patient information and belongs under the same minimum-necessary thinking as any other system.
  • Microsoft states directly that having an agreement does not on its own achieve compliance: your programme and your configuration remain yours.

Does Microsoft Copilot sign a business associate agreement?

Yes. Microsoft offers one. A commercial Office 365 or Microsoft 365 licence carrying Microsoft 365 Copilot or Copilot Chat. Also in scope for Government Community Cloud tenants. Nothing to request. The agreement is available by default through the Product Terms to customers that are covered entities or business associates.

See their documentation.

What this means in practice

The name is doing a lot of damage here. Microsoft ships several distinct things called Copilot, and only some of them appear on the in-scope list. Microsoft 365 Copilot and Microsoft 365 Copilot Chat are named for Office 365 Commercial and for the Government Community Cloud; the free consumer Copilot someone signs into with a personal account is not. Same brand, same icon, entirely different contractual position.

Where it is in scope, the agreement is already there: it arrives through the Product Terms with the rest of the tenant, so there is nothing to arrange. That makes the practical control an identity question rather than a procurement one: is the person signed in with the organisational account, or their own?

The part no agreement touches is what gets typed. A prompt containing a patient's history is a use of patient information, and minimum-necessary thinking applies to it exactly as it does to an email. Staff who would never email a full chart will happily paste one into an assistant, because it does not feel like sending it anywhere.

How organizations get this wrong

  • Assuming every product called Copilot is covered, when the consumer version is not named in the in-scope list at all.
  • Letting staff use Copilot signed in with a personal Microsoft account on a work device, which leaves the tenant and the agreement behind.
  • Attaching third-party plugins or connectors and assuming Microsoft's agreement follows the data into them.
  • Treating prompts as private scratch space rather than as a disclosure subject to the same judgement as any other.

What the agreement does not cover

  • The free consumer Copilot. It is not named among the in-scope Office 365 commercial services, and Microsoft's list is a positive one: absence is not an oversight to read past.
  • Third-party plugins, connectors and agents attached to Copilot.
  • What your staff choose to type into it, which no agreement can constrain.

Alternatives

  • ChatGPT

    The other mainstream assistant with a published position on patient data

  • Google Gemini

    Covered inside Google Workspace once an administrator accepts the agreement

Keep a record of your Microsoft Copilot agreement

Sources

  1. Health Insurance Portability and Accountability Act (HIPAA) & HITECH Act: Microsoft Compliance: Microsoft. Published July 29, 2025. Read August 10, 2026.

Microsoft can change these terms at any time. If something here no longer matches what Microsoft tells you, tell us.