Is Claude HIPAA compliant? What the HIPAA-ready offering and BAA actually cover

Claude, powered by Anthropic, can be used with protected health information only through a HIPAA-ready configuration covered by a Business Associate Agreement: a Claude Enterprise plan with HIPAA enabled by the Primary Owner, or a HIPAA-ready API organization. No tool is HIPAA compliant on its own; compliance depends on how you configure and use it. Team, Pro, Max and Free plans cannot enable HIPAA, and some Enterprise features stay outside the BAA.

Which Claude plans and routes can sign a BAA?

Anthropic lists a HIPAA-ready configuration with a BAA among its compliance credentials, alongside SOC 2 Type I and Type II, ISO 27001:2022 and ISO/IEC 42001:2023. The BAA attaches to specific services, not to the Claude brand. The table shows each route as Anthropic documents it in October 2026.

Who is this for? Anthropic names healthcare providers, health plans and insurers, healthcare data processors, and business associates that handle PHI for covered entities. Its own test is simple: if you will process PHI through Claude, you need the HIPAA-ready offering with a BAA. That includes companies outside healthcare that act as business associates, such as billing services, benefits administrators and some software vendors.

What does the BAA cover on Claude Enterprise?

Turning on HIPAA does not bring every feature under the agreement. Anthropic sorts features into three groups: covered, available but not covered, and unavailable. Process PHI only in covered features. The authoritative list is the Implementation Guide for HIPAA Entities on the Anthropic Trust Center; the summary below comes from the Anthropic Privacy Center as of October 2026.

Can clinicians or developers use Claude Code and Cowork with PHI?

Only after a second step. Enabling HIPAA alone does not bring Claude Code or Cowork under the BAA. The Primary Owner must also apply the HIPAA configuration to Claude Code (local mode) and Cowork (local mode). Anthropic says that configuration is currently available only to organizations with an Anthropic account team, and the Primary Owner cannot remove it once applied. Local mode means Claude Code in the terminal, the Code tab of Claude Desktop, and Cowork in Claude Desktop.

With the configuration applied, those local sessions are covered when members sign in with their Enterprise account and Claude Code connects directly to Anthropic. Several common setups remain outside it: the VS Code and JetBrains extensions, Claude Code through Bedrock, Google Cloud or Microsoft Foundry, and Claude Code through an LLM gateway or custom base URL. Cloud features turn off entirely, including cloud sessions, Remote Control, Claude Code Review, Claude Security and session sharing links. Connectors, local MCP servers, desktop extensions and every kind of skill remain uncovered. Skill and plugin security scanning is also unavailable under the configuration, so review each skill yourself before you publish it to members.

Without the configuration, Claude Code is covered only if your organization has zero data retention for Claude Code, which Anthropic grants to qualified accounts. Cowork is not covered at all in that case.

What does the BAA cover if you build on the Claude API?

Teams building their own patient-facing or back-office apps use a HIPAA-ready API organization rather than the Enterprise chat plan. The Messages API is covered, but only some of its features. Anything not on the covered list is outside the BAA, and several features are switched off entirely for HIPAA-ready API users. Design around these limits before you write code, because swapping out batch jobs or file uploads late in a build is expensive.

How do you enable HIPAA on Claude Enterprise?

• Confirm the Primary Owner. Only that person can accept the BAA; other Owners and Admins cannot complete the flow.
• Request the Implementation Guide from the Anthropic Trust Center and have counsel review it with the BAA. Anthropic auto-approves requests from domains matching existing customer accounts.
• Note that the self-serve BAA is a standard agreement that cannot be modified. If you need negotiated terms, talk to Anthropic sales first.
• Plan for settings to reset. Enabling HIPAA returns some configurations to defaults, and the onboarding flow lists which ones.
• Sign in as Primary Owner, go to Organization settings, then Data and privacy, then HIPAA Compliance, and click Enable.
• Download and review the BAA, then the Implementation Guide, then click Accept and enable HIPAA. A checkmark confirms the change.
• Treat it as permanent. Anthropic says the change cannot be reversed from organization settings.

One trap for existing API customers: a BAA signed for the Claude API before December 2, 2025 covers only API usage. It does not extend to a HIPAA-ready Enterprise plan, so you need a new BAA through your account team. BAAs signed after that date can cover both under a single agreement.

What stays your responsibility after the BAA is signed?

• Deciding which workflows may touch PHI and applying the minimum necessary standard to each.
• Keeping PHI out of every feature marked available but not covered. Anthropic says administrators who enable those features are responsible for compliant use.
• Signing your own BAAs with any third party a connector sends data to, such as a document store or ticketing system.
• Turning on the Compliance API and reviewing it. Local Claude Code and Cowork sessions are readable there for up to 30 days when it is on.
• Securing OpenTelemetry exports, which Anthropic marks as your responsibility; Cowork events include session content by default.
• Clearing local data on members' computers. Claude Code memory stays on the machine until someone deletes it.
• Training staff, running access reviews, and documenting all of this in your HIPAA risk analysis.

What about finance, legal and insurance teams?

HIPAA governs health information, so a bank, law firm or property and casualty carrier usually needs different controls. Health insurers are the exception: Anthropic lists health plans and insurers among the organizations the HIPAA-ready offering is designed for. For the rest, the relevant Enterprise controls are custom data retention with a 30-day minimum, audit logs, the Compliance API for exporting chats and activity, customer-managed encryption keys, US-only inference, SCIM provisioning and IP allowlisting. Map each of your recordkeeping, supervision and confidentiality obligations to one of those controls, and get your compliance team to sign off on the mapping before go-live.

Where do HIPAA rollouts of Claude go wrong?

• Starting on Team. Team cannot enable HIPAA, and moving later means a one-way migration to Enterprise.
• Turning on connectors for convenience. The BAA covers chat, but the moment Claude pulls PHI from or pushes it to a third-party service, that flow is outside it.
• Letting developers use IDE extensions or a cloud gateway. Those Claude Code routes are not covered, even with the HIPAA configuration applied.
• Re-enabling Skills without review. Skills are off by default after HIPAA is enabled for a reason: they are not covered and scanning is unavailable.
• Assuming an old API BAA carries over. Pre-December 2025 agreements do not cover Enterprise.