Email Flows for Telehealth Companies
The email flows a telehealth brand needs, triggered by care events: what an email can say, when HIPAA marketing rules apply, required notices.
Article summary
TL;DR
A telehealth brand's emails follow the patient's case, not a calendar: intake started, order placed, clinician decision, shipment, next refill, failed payment. Each email moves the patient one step and carries no clinical detail. Before any promotional email, check whether HIPAA's marketing rules apply, and send the subscription notices card networks and state laws require.
- Under HIPAA, a refill reminder about a drug "currently being prescribed" is not marketing, as long as any third-party payment only covers the cost of sending it (45 CFR 164.501).
- Other marketing that uses protected health information needs the patient's written authorization (45 CFR 164.508(a)(3)).
- In 2023, the FTC alleged BetterHelp used customers' email addresses to have Facebook find and target similar people; it agreed to pay $7.8 million.
- Visa requires a reminder at least 7 days before a trial or introductory price ends (rules of April 18, 2026).
- Automated flows click at 5.58% against 1.69% for campaigns (Klaviyo, 183,000+ customers, all industries, 2026).
On this page
This guide is part of our playbook on the best ecommerce platform for telehealth companies. The general guide, for any store: triggered email campaigns. Texts are covered in SMS flows for telehealth companies.
The email flows a telehealth brand needs
A telehealth brand needs about ten flows, grouped around the case: before the decision, after it, and around each refill.
| Flow | Trigger | Timing | What it says |
|---|---|---|---|
| 1. Welcome | Email signup on a landing page | Right away, then 2 or 3 emails over a week | How the service works: intake, review by a licensed clinician, delivery, price |
| 2. Unfinished intake | Intake started, not submitted | 1 hour, then 24 hours | A link back to the saved intake. Nothing about the answers |
| 3. Abandoned checkout | Checkout started, no payment | Within hours, then 1 day | Link back to checkout, total, how the review works |
| 4. Order received | Payment or card hold | Right away | What happens next, how long the review takes, that the card is charged only if approved (if that is your model) |
| 5. Case update | Clinician decision | On the event | "Your case has an update" and a portal link |
| 6. Shipped | Pharmacy ships | On the event | Tracking link, plain-packaging note |
| 7. Next refill notice | Upcoming rebill | A few days before the charge | Date, amount, how to skip, pause or cancel |
| 8. Failed payment | Rebill declined | Day 0, then within a week | Card update link, what happens to the next shipment |
| 9. Cancellation confirmation | Plan cancelled | Right away | End date, what was charged, how to restart |
| 10. Win-back | NoActive plan | 30 to 90 days later | The service, the price, a new intake link |
Fig. 1The 10 flows along the patient's case
- Signup and intake1. Welcome · 2. Unfinished intake
- Checkout3. Abandoned checkout · 4. Order received
- Clinician decision5. Case update
- Pharmacy ships6. Shipped
- Before each rebill7. Next refill notice · 8. Failed payment
- Plan ends9. Cancellation confirmation · 10. Win-back
Before the decision, after it, and around each refill.
Abandoned intakes and checkouts have their own guide: abandoned cart recovery for telehealth companies.
Trigger on care events, not on the calendar
In telehealth, the clock is the case. An email sent on day 30 from signup can land before the clinician decides, or after a cancelled shipment.
Start care-status emails from the case status
Submitted, approved, declined, shipped, delivered.
Time refill emails from the shipment
Not from signup. If the charge comes at ship date plus 30 days, the notice goes a few days before that date.
Stop every flow when a case is declined or cancelled
A refill reminder after a decline is the kind of email that turns into a complaint.
Exclude active patients from win-back
And from promotional sends about the plan they already have.
Example
A patient is approved on day 2, the pharmacy ships on day 4. The next charge is due on day 34 (ship day plus a 30-day cycle). The refill notice goes on day 31, the shipped email on day 4, and nothing goes out on "day 30 from signup".
This is how a telehealth stack with storefront, doctors, pharmacy and payments like Tagada Rx bills: "Recurring treatments rebill the day the pharmacy ships", not on a calendar date14Tagada docs, How Tagada Rx works, read November 2, 2026. More on the billing side in subscription billing for telehealth companies.
What can go in a telehealth email
Write emails that a roommate could read over the patient's shoulder without learning anything medical.
| Write | Keep out of the email |
|---|---|
| "Your case has an update" and a portal link | The clinician's decision or notes |
| Order number, amount, next charge date | Treatment names in subject lines and previews |
| Tracking link, delivery window | Intake answers, symptoms, conditions |
| How to skip, pause or cancel | Personal results or progress claims |
| The brand name and a support address | Messages from the care team (link to the portal instead) |
- Neutral subject lines: "Your order has shipped", "Your next delivery is on March 4".
- Content-free notifications: say a message is waiting, link to the portal, never copy the message.
- No medical claims: emails promise service steps (review, delivery, support), not outcomes.
Fig. 2What a roommate sees on the lock screen
What each email keeps out
- Case update: not the clinician's decision or notes.
- Shipped: no treatment name in the subject or preview.
- New message: a link to the portal, never the message text.
- Next delivery: date and options, no progress claims.
- EmailMonYour case has an updateLog in to your patient portal to see it.
- EmailWedYour order has shippedTrack your delivery with the link inside.
- EmailFriYou have a new message from your care teamRead it in your patient portal.
- EmailMar 1Your next delivery is on March 4Skip, pause or cancel in your account.
A status and a link, never the medical part.
Does HIPAA apply to your marketing emails?
It depends on who you are. HIPAA covers health plans, clearinghouses and health care providers that transmit health information electronically in a standard transaction, such as an insurance claim345 CFR 160.103, Definitions, "covered entity" and "business associate", current as of October 29, 2026. Many cash-pay brands sit next to a medical practice, and the answer can differ for each entity.
If HIPAA applies, the test is whether the email is "marketing"145 CFR 164.501, Definitions, "marketing", current as of October 29, 2026:
| Marketing under HIPAA? | Rule | |
|---|---|---|
| Refill reminder about a drug currently prescribed | NoIf any third-party payment only covers the cost of sending it | 45 CFR 164.501, (2)(i)145 CFR 164.501, Definitions, "marketing", current as of October 29, 2026 |
| Describing your own health-related services | NoUnless a third party pays you to send it | 45 CFR 164.501, (2)(ii)(B)145 CFR 164.501, Definitions, "marketing", current as of October 29, 2026 |
| Treatment and care coordination | NoUnless a third party pays you to send it | 45 CFR 164.501, (2)(ii)(A)145 CFR 164.501, Definitions, "marketing", current as of October 29, 2026 |
| Promoting a third party's product, using patient data | Yes | Written authorization needed, 45 CFR 164.508(a)(3)245 CFR 164.508(a)(3), Authorization required: marketing, current as of October 29, 2026 |
Fig. 3Which emails count as marketing under HIPAA
- Refill reminder about a drug currently prescribedNo, if any third-party payment only covers the cost of sending it45 CFR 164.501, (2)(i)
- Describing your own health-related servicesNo, unless a third party pays you to send it45 CFR 164.501, (2)(ii)(B)
- Treatment and care coordinationNo, unless a third party pays you to send it45 CFR 164.501, (2)(ii)(A)
- Promoting a third party's product, using patient dataYesWritten authorization needed, 45 CFR 164.508(a)(3)
Only for entities HIPAA covers.
- Vendors: an email tool that "creates, receives, maintains, or transmits" protected health information for a covered entity is a business associate, which means a business associate agreement345 CFR 160.103, Definitions, "covered entity" and "business associate", current as of October 29, 2026.
- Security is not permission. An encrypted email that needs an authorization still needs it.
If HIPAA does not apply, the FTC does. Its Health Breach Notification Rule covers health apps and records "not covered by" HIPAA5FTC, Health Breach Notification Rule, 89 FR 47028, published May 30, 2024, effective July 29, 2024. In the BetterHelp case, the FTC alleged the company used customers' email addresses so Facebook could "identify similar consumers and target them with advertisements"4FTC, FTC to ban BetterHelp from revealing consumers' data, press release, March 2, 2023 (proposed order at the time). Never upload patient lists to ad platforms without a legal review.
Watch out
A newsletter signup is not a HIPAA authorization, and an email list built from intake forms is not a marketing list. Keep patient data and marketing consent in separate fields. This is general information, not legal advice: confirm your status with a health care lawyer.
Subscription emails the rules require
Treatment plans billed every cycle are subscriptions. Some emails are required, not optional.
| When | Required by | |
|---|---|---|
| Terms and how to cancel | At signup | ROSCA: clear terms before billing, express consent, simple cancellation10Restore Online Shoppers' Confidence Act, 15 U.S.C. § 8403; Mastercard8Mastercard, Subscription/recurring payments and negative option billing merchants: FAQs, 2022 |
| Trial or intro price ending | At least 7 days before | Visa7Visa Core Rules and Visa Product and Service Rules, edition of April 18, 2026, table 5-21 |
| Notice before billing | Before renewals, for cycles of 6 months or less | Mastercard8Mastercard, Subscription/recurring payments and negative option billing merchants: FAQs, 2022 |
| Annual reminder | Once a year | California, contracts since July 1, 20259California Business and Professions Code § 17602, contracts from July 1, 2025 |
| Cancellation confirmation | When the plan ends | Proof of cancellation, and fewer disputes |
Tagada follows Visa and Mastercard rules and the laws that apply to payments.
Regulators look at this. In its July 29, 2026 complaint, the FTC alleges Hims & Hers made cancellation hard "by hiding the cancellation button from consumers"11FTC, FTC and states act against Hims & Hers, press release, July 29, 2026 (allegations, case pending). These are allegations in an open case. Cancellation rules by state are in subscription cancellations for telehealth.
Commercial emails: the CAN-SPAM basics
Promotional emails (win-back, new services) follow CAN-SPAM, whatever HIPAA says6FTC, CAN-SPAM Act: A compliance guide for business, read November 2, 2026:
- Accurate sender and an honest subject line.
- A valid physical postal address.
- An opt-out, honored within 10 business days.
- Transactional content first: if it does not appear "mainly at the beginning", the email is treated as commercial6FTC, CAN-SPAM Act: A compliance guide for business, read November 2, 2026.
Each violating email can cost up to $53,088 (FTC, January 2024 inflation adjustment).
Each violating email can cost up to $53,088 (FTC, inflation adjustment of January 2024)6FTC, CAN-SPAM Act: A compliance guide for business, read November 2, 2026.
Measure your flows
| Metric | Read it by | Watch for |
|---|---|---|
| Intake completion after the reminder | Flow 2 | Where patients drop in the intake |
| Paid orders per recipient | Flows 1, 3, 10 | Which email sells |
| Refills charged on time | Flow 7 | Skips and cancellations right after the notice |
| Cards updated | Flow 8 | Recovered rebills |
| Unsubscribe and spam complaints | Each email | Too many or unclear emails |
| Disputes after a rebill | Notices sent or not | Missing notices |
There is no published email benchmark for telehealth. For scale, Klaviyo reports flows at a 5.58% click rate against 1.69% for campaigns, across 183,000+ customers in all industries12Klaviyo, 2026 Email Marketing Benchmarks by Industry, read November 2, 2026.
Fig. 4Flows get clicked more than campaigns
All industries: compare your flows with each other.
Klaviyo itself is not an option for a telehealth brand: its Acceptable Use Policy (April 9, 2026) says you may not use its services for "Prescription medications, pharmaceutical products or services, medical therapies, telehealth"16Klaviyo, Acceptable Use Policy, updated April 9, 2026. Compare your flows with each other, month to month.
Payment failures are covered in failed payment recovery for telehealth companies.
How Tagada helps
Transactional emails from the checkout, on your own domain
The Tagada checkout sends transactional emails on its own events15Tagada docs, Emails, read November 2, 2026, with "24/7 human support on Slack Connect"17TagadaPay, homepage, read November 2, 2026 from TagadaPay:
- Order paid, rebill receipt, upcoming rebill (3 days before the next billing cycle), payment failed, cancellation, abandoned checkout (trigger delay from 10 minutes to 48 hours)15Tagada docs, Emails, read November 2, 2026
- Your own sender domain, set up with SPF, DKIM and DMARC records15Tagada docs, Emails, read November 2, 2026
- Subscriptions with trials, billing cycles, retries and automatic recovery
Building the whole telehealth brand? Tagada Rx runs "Storefront, doctors, pharmacy and payments in one stack"13Tagada, Tagada Rx, read November 2, 2026, and its emails are "content-free": "You have a new message from your care team" and a portal link, never the message text14Tagada docs, How Tagada Rx works, read November 2, 2026. US patients only, by selection.

Frequently asked questions
What email flows does a telehealth company need?
Can a telehealth refill reminder mention the medication?
Do I need a HIPAA-compliant email platform?
Can I use my patient list for Facebook or Google audiences?
Which subscription emails are mandatory?
Sources
Checked November 2, 2026- 45 CFR 164.501, Definitions, "marketing", current as of October 29, 2026
- 45 CFR 164.508(a)(3), Authorization required: marketing, current as of October 29, 2026
- 45 CFR 160.103, Definitions, "covered entity" and "business associate", current as of October 29, 2026
- FTC, FTC to ban BetterHelp from revealing consumers' data, press release, March 2, 2023 (proposed order at the time)
- FTC, Health Breach Notification Rule, 89 FR 47028, published May 30, 2024, effective July 29, 2024
- FTC, CAN-SPAM Act: A compliance guide for business, read November 2, 2026
- Visa Core Rules and Visa Product and Service Rules, edition of April 18, 2026, table 5-21
- Mastercard, Subscription/recurring payments and negative option billing merchants: FAQs, 2022
- California Business and Professions Code § 17602, contracts from July 1, 2025
- Restore Online Shoppers' Confidence Act, 15 U.S.C. § 8403
- FTC, FTC and states act against Hims & Hers, press release, July 29, 2026 (allegations, case pending)
- Klaviyo, 2026 Email Marketing Benchmarks by Industry, read November 2, 2026
- Tagada, Tagada Rx, read November 2, 2026
- Tagada docs, How Tagada Rx works, read November 2, 2026
- Tagada docs, Emails, read November 2, 2026
- Klaviyo, Acceptable Use Policy, updated April 9, 2026
- TagadaPay, homepage, read November 2, 2026
Tagada
Emails that follow the case, with nothing medical inside
Funnels, one-click upsells, subscription billing and payment routing, on one customer record.
- 01Create your free account
- 02Connect your store or build a checkout
- 03Launch funnels, upsells and subscriptions
