MSSanté refers to a trusted space, not a software. Mailiz is a messaging software that operates within this trusted space. Confusing the two is like comparing a road network with a car brand. This distinction underpins all further reasoning for choosing a secure health messaging service in 2026.
Trusted space MSSanté and operators: the mechanism to know
The Digital Health Agency (ANS) defines the security and interoperability rules that form the trusted space MSSanté. Any operator that adheres to these rules can offer compatible mailboxes.
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Mailiz is the public operator, directly managed by the ANS and funded by public authorities. Other private operators (Lifen, Apicrypt in its compatible version, some health software publishers) also provide MSSanté mailboxes. All messages circulate within the same trusted space, regardless of the sending or receiving operator.
To understand the differences between Mailiz and MSSanté, it is important to remember that the question is not “one or the other,” but “which MSSanté operator corresponds to my professional practice.”
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Pro Santé Connect mandatory in 2026: what this changes for operator choice
The electronic identification doctrine of the ANS mandates a shift towards strong authentication via Pro Santé Connect (PSC) for sensitive services, with generalization planned for January 1, 2026. Any MSSanté messaging must support connection via CPS or e-CPS through Pro Santé Connect.
This obligation levels the security among operators. Mailiz, Lifen, or another MSSanté operator will apply the same authentication foundation. Therefore, pure security criteria no longer allow for differentiation between solutions.
The choice shifts towards three concrete axes: the ergonomics of the interface, integration with the business software already used in the practice or establishment, and additional features (notifications, management of large attachments, enriched directory).
Free Mailiz versus paid operators: concrete selection criteria
Mailiz is accessible without a subscription for every healthcare professional holding a CPS or e-CPS card. The service has been available for over ten years and provides access to the national directory of healthcare professionals. The information in the directory comes from the Orders for RPPS professionals and from the Regional Health Agencies for ADELI professionals.
Mailiz is suitable for an individual liberal practice that does not require advanced integration with management software. The webmail interface is sufficient to send a report or receive laboratory results.
Private operators charge a subscription but offer functions that Mailiz does not cover natively:
- Direct integration into the business software (the practitioner sends and receives their MSSanté messages without leaving their consultation tool, as is the case with Doctolib or some management software)
- Automated sending of documents to the DMP or the patient’s Mon espace santé from the same interface
- Multi-practitioner management with differentiated access rights, suitable for group practices or multi-professional health centers
- Enhanced tracking dashboards for exchanges and acknowledgments of receipt
A professional in simple liberal practice, without shared secretarial support, gains little benefit from a paid operator. A group structure or an establishment benefits from fluidity with an operator integrated into the business software.
Extension to the medico-social sector via RPPS+: a selection criterion for structures
The RPPS+ portal now opens access to a digital identity, and thus to a nominative MSSanté messaging, for social and medico-social professionals. Specialized educators, nursing assistants in ESMS, social workers can obtain an MSSanté mailbox subject to authorization by their employer.
For a nursing home, a home care service, or a coordinated care network, this extension changes the game. Mailiz allows for the opening of nominative accounts for these professionals by role, but managing a large volume of accounts with varied authorizations may justify an operator offering a centralized administration console.
Check the capacity for managing role-based accounts
Before choosing, a director of a medico-social establishment should ask three questions to the prospective operator: how many different role profiles can be configured, who assigns and revokes authorizations, and how does portability work if the establishment changes operators.
Mailiz manages nominative accounts one by one, which remains viable for a small structure. Beyond twenty active accounts with distinct roles, an operator with centralized management reduces the administrative burden.
Secure health messaging: the MSSanté directory as a decisive factor
Regardless of the chosen operator, the mailbox appears in the national MSSanté directory. This point is often underestimated: a hospital correspondent or a laboratory will look for the recipient in this directory, not in a private address book.
Creating a Mailiz account automatically registers the address in the directory. With a third-party operator, publication in the MSSanté directory remains mandatory, but the propagation time may vary. Ensuring that the address is visible in the directory after activation prevents lost messages in the initial weeks.
The choice between Mailiz and another MSSanté operator in 2026 boils down to three variables: the size of the structure, the business software already in place, and the need to manage multiple role accounts. Security is no longer part of the equation, as Pro Santé Connect applies to all.