Fax is still a thing — here’s who still uses it and why
Every few years someone declares fax dead. Then a Medicaid office, a courthouse or an insurance claims desk asks for a fax. Fax survives not because anyone loves it, but because whole industries quietly never stopped relying on it.
Every few years someone declares the fax machine dead. Then a Medicaid office, a county courthouse, or an insurance claims desk quietly asks you to fax a document. Fax has outlived every prediction, not because anyone loves it, but because a surprising number of institutions never stopped relying on it.
Who still uses fax — and why they won’t give it up
Fax survives in the segments where a verifiable, permanent record of a sent document matters and where the “receiving” system has been built around it for decades. The same industries come up again and again:
- Healthcare — referrals, prior authorisations and PHI. Hospitals, clinics, pharmacies and billing offices still fax an enormous volume of referrals, discharge summaries, clinical records and prior-authorisation requests. The documents are human-written and hard to standardise, and fax is treated as a secure, HIPAA-compliant way to transmit them.
- Medicaid and state agencies — applications and verification. Many Medicaid and benefits offices still accept applications, income verification, and supporting documents by fax. If you or a client deals with a benefits application, the fax number on the form is often the fastest route to a decision — and sometimes the only practical one for a paper-heavy packet.
- Legal and courts. Attorneys and courts use fax for signed contracts, court orders, subpoenas and time-sensitive filings. A fax transmission report is a concrete, timestamped record that a document was sent — and in a dispute, that record can be the difference between winning and losing.
- Government offices. The IRS, the Social Security Administration (disability claims and appeals), DMVs, county clerks, immigration offices and municipal courts all maintain active fax numbers for submitted forms.
- Insurance. Claims submissions, prior authorisations, appeals and policy documents move through fax all day. Many carriers keep dedicated fax numbers per department; faxing is often the fastest way to get a document into their system with proof of delivery.
- Real estate closings. A closing involves stacks of signed documents — addendums, disclosures, wiring instructions — and fax is still used to move time-critical pages securely.
Why it hangs on
Strip the nostalgia away and fax has real properties that email lacks:
- A verifiable transmission record. The confirmation slip or report proves a document was sent and received. Email receipts are weaker and easier to dispute.
- It fits unstructured human documents. Healthcare and legal work are built on narrative documents that resist clean data models. Fax transmits them whole, unaltered.
- The receiving system expects it. A benefits office or claims desk already has a fax number, a fax server and a routing habit. Fitting their process is often easier than converting them.
- A perception of security. Right or wrong, fax is seen as a closed, point-to-point channel — which is exactly why regulated industries kept it.
One honest nuance: healthcare is starting to move on
It’s fair to note the tide is slowly turning. In 2026 the US Centers for Medicare & Medicaid Services finalised a rule (CMS-0053-F) that establishes national standards for transmitting clinical claims attachments electronically, which is projected to save the healthcare industry hundreds of millions a year by phasing out fax for claims documentation. Fax isn’t immortal — but that rule applies to Medicare claims attachments. Medicaid applications, referrals, prior authorisations, legal filings, government forms and insurance claims still run on fax today, and will for years.
Doing it without a machine
The best part about fax in 2026 is that you almost certainly don’t own a fax machine. Online fax — sending to a real fax number from your computer, tablet or email — gives you the same receiver-side delivery and transmission record without paper, toner or a phone line. No waiting next to a machine, no busy retries, no misaligned cover sheets.
When a form, contract or verification document explicitly wants a fax, don’t fight it. Send it by fax — from your desk, with a record — and move on with your day.