PXCMail vs Paubox
Paubox pioneered “encrypt everything without the patient noticing” and serves thousands of practices. PXCMail Gateway follows the same idea. The differences are in what else is included, how pricing works, and whether you can also get the mailbox from the same vendor.
| Paubox Email Suite | PXCMail | |
|---|---|---|
| Model | Gateway in front of Google/Microsoft | Gateway, or full Hosted mailbox |
| Pricing | Tiered (Standard / Plus / Premium), quoted per user; DLP and inbound security on higher tiers | $6 Gateway flat, $12 Hosted, $18 Pro, published |
| Encrypted delivery | TLS first, portal fallback | TLS first, one-time-code fallback |
| PHI detection / DLP | Higher tier | Every plan |
| Inbound threat protection | Higher tier, mature | Spam, malware and impersonation banner included; URL detonation on the roadmap |
| Mailbox from the same vendor | No | Hosted, with device policies and your own key |
| Audit trail & annual compliance letter | Reporting | Per-message audit, exports, annual letter |
| Published trust evidence | Established, HITRUST | Pentest and SOC 2 ROADMAP |
| Support | Business hours | 15-minute response; DNS on a call |
Paubox details from public materials, October 2026; verify current plans. We will update this table when we are wrong.
Honest summary
Paubox has a longer track record and stronger inbound security today. PXCMail publishes flat pricing, includes PHI detection in every plan, offers a managed mailbox with device policies, and gives each practice its own key. If you are evaluating both, run the trial side by side on the same domain — we’ll help you set it up.
Where Paubox is stronger
- Track record. Paubox has served thousands of practices for years and made “encrypt without the patient noticing” the normal expectation. PXCMail is newer; our SOC 2 Type I and independent pentest letter are ROADMAP, and we say so.
- Inbound security. Paubox’s higher tiers include a mature inbound suite. PXCMail includes spam and malware filtering; URL detonation is ROADMAP. If inbound protection is the reason you buy, weigh this line heavily.
- Published trust evidence. Paubox publishes HITRUST. We publish our security page, subprocessor list and roadmap, and will add attestations as they are issued, not before.
Where PXCMail is stronger
- Price you can read. Gateway $6, Hosted $12, Hosted Pro $18 per seat per month, billed yearly, $49 minimum, 14-day trial with nothing charged. No quote, no tier to negotiate.
- Detection on every plan. Identifiers (SSN, MRN, account numbers), document fingerprints, ICD-10 and CPT codes, custom patterns, attachment scanning, with five actions: deliver, encrypt, warn, hold, block. Test mode before enforcement.
- A mailbox from the same vendor. Hosted adds a 50 GB mailbox, native Outlook, iPhone and Android sync, device policies, shared mailboxes, free migration up to 50 seats and a dedicated organization key.
- Evidence. A per-message record of sender, recipient, policy decision and reason, encryption method and opens; a quarterly compliance report; an annual safeguards letter; evidence packs mapped to regulator questions.
- Archive included. One year of journaled, immutable archive on every plan; 6-year healthcare retention for $3 more per Gateway seat; legal hold on Pro.
- Support you can reach. Human reply within 15 minutes on chat during business hours, 24/7 for outages, and DNS done with you on a call.
A week at Lakeside Family Dental
Lakeside is a 12-person dental office on Google Workspace with Dentrix. On Monday frontdesk@ emails a treatment plan; the Healthcare pack sees a patient name beside an insurance ID and applies encrypt, and the patient opens it with a one-time code on her phone. On Tuesday a referral goes to an oral surgeon who publishes an S/MIME certificate; it is S/MIME-encrypted automatically. On Wednesday a pre-authorization from insurance@ to a payer whose server does TLS is delivered over TLS and logged as such. On Thursday a new hire pastes a spreadsheet of patient balances into a message to her personal address; the policy holds it, the office manager sees the reason and releases nothing. On Friday the office manager exports the week’s audit records for the insurance renewal. With Paubox the Monday, Tuesday and Wednesday messages would be handled on the same principle; the Thursday hold and the Friday export are where the two products differ on the plan most small offices buy.
Total cost for a 12-person office
| Line | Paubox Email Suite | PXCMail Gateway |
|---|---|---|
| Google Workspace or Microsoft 365 | Your current plan, unchanged | Your current plan, unchanged |
| Encryption layer, 12 seats | Quoted per user; DLP and inbound security on higher tiers | $72 a month ($6 × 12), billed yearly |
| 6-year archive | Quoted | + $36 a month ($9 instead of $6 per seat) = $108 |
| Mailbox from the same vendor | Not offered | Hosted $144 a month; Hosted Pro $216 |
| Setup | Ask | Included, on a call; migration free to 50 seats |
We do not print Paubox’s prices because they are quoted. Get the quote for the tier that includes DLP, since that is the like-for-like line, and set it beside $72.
By the numbers
- Coalition’s 2026 Cyber Claims Report: BEC and funds-transfer fraud were 58% of all claims, average BEC loss about $27,000 (Coalition).
- The FBI’s IC3 reported 21,442 BEC complaints and $2.77 billion in losses for 2024 (IC3 2024 report).
- HHS resolution agreements are a tail risk, not the common case; the list is public (HHS). The common case is a renewal questionnaire you cannot answer with evidence.
Who should pick which
Pick Paubox if inbound threat protection on a mature suite is your main purchase, if your carrier or a large partner asks for HITRUST specifically, or if you are already on Paubox and the audit and detection gaps do not affect you.
Pick PXCMail if you want detection and the five actions without a higher tier, a per-message audit trail and an annual letter for your carrier or auditor, published pricing you can budget for, a mailbox and device policies from the same vendor, or a human on a call for setup. Also if you are an MSP who needs one partner console across clinics, CPA firms, title companies and RIAs.
If you are undecided, run both for a week on separate pilot groups and compare the two audit trails. The switch guide shows the rule mapping.
Questions we get about this comparison
Is the recipient experience the same?
Similar. Both deliver over TLS first. On fallback Paubox uses a portal; PXCMail sends a notification and the recipient opens with a one-time code by SMS or email, no account, 30-day expiry, every open logged. Sign-in with Google, Apple or Microsoft is ROADMAP.
Do I need to change my Google or Microsoft plan?
No. Gateway works with the plan you have; the Google and Microsoft pages price Business Starter and Business Basic plus Gateway.
Does PXCMail have an Outlook button like Paubox?
Not yet; add-ins are ROADMAP. Staff type [SECURE] in the subject to force encryption, and detection packs handle the rest.
What does the BAA cover?
PXCMail as your business associate for the mail we process, archive and support, with a 42 CFR Part 2 QSOA where it applies. It is signed electronically at signup. Our BAA
How current is the table above?
October 2026, from Paubox’s public materials. Tell us what is wrong and we will fix it.