Medical Identity Theft: Protect Your Health & Finances
Medical identity theft occurs when someone uses your personal identifying information, such as your name, Social Security number, or health insurance policy number, to obtain medical services, prescription drugs, or file fraudulent insurance claims. This insidious crime not only leads to significant financial losses but also contaminates your medical records with false information, potentially endangering your health with incorrect diagnoses or treatments. Victims often discover the theft months or even years later, facing a complex and arduous process to rectify the damage. The consequences are severe, ranging from unexpected medical bills and damaged credit scores to being denied insurance coverage or even receiving inappropriate medical care due to a compromised health history. According to the Identity Theft Resource Center (ITRC), medical identity theft can take an average of 200 hours to resolve, and victims often incur out-of-pocket costs exceeding $13,500, even before considering the emotional toll. The FBI's Internet Crime Complaint Center (IC3) consistently reports healthcare-related fraud as a significant concern, with medical identity theft being a critical component of this broader issue, leading to an average loss of $20,000 per victim and a typical duration of months to years to fully resolve.
Common Tactics
- • Scammers exploit data breaches at healthcare providers or insurance companies to steal large batches of patient information, then sell this data on dark web marketplaces.
- • They engage in phishing scams, sending fake emails or texts impersonating healthcare providers or insurers to trick individuals into revealing their personal and medical details.
- • Criminals may directly steal physical documents containing medical information through dumpster diving or by breaking into homes or vehicles.
- • Some fraudsters work within healthcare systems, using their access to internal databases to steal patient identities for personal gain or to sell.
- • They might approach vulnerable individuals, offering cash or other incentives in exchange for their insurance card or personal information, which is then used for fraudulent services.
- • Scammers create fake clinics or medical practices to bill insurance companies for services never rendered, using stolen patient identities to justify the claims.
How to Identify
- You receive a bill for medical services, procedures, or prescriptions that you never received or authorized.
- Your health insurance company sends you an Explanation of Benefits (EOB) statement detailing services you did not obtain.
- A debt collector contacts you about an unpaid medical bill that you do not recognize or for services you never had.
- Your health insurance coverage is denied because your benefits have been exhausted, but you haven't used them extensively.
- You find inaccuracies or unfamiliar entries in your medical records when you request a copy from your healthcare provider.
- You are unable to obtain new health insurance or receive a lower credit score due to medical debts you don't recognize.
How to Protect Yourself
- Regularly review all Explanation of Benefits (EOB) statements from your insurer and medical bills from providers for accuracy, questioning any unfamiliar charges.
- Obtain and review copies of your medical records from all healthcare providers annually to check for discrepancies or services you didn't receive.
- Shred all medical documents, insurance statements, and prescription labels before discarding them to prevent dumpster diving theft.
- Be wary of unsolicited calls, emails, or texts asking for your medical information, and never share it unless you initiated the contact and verified the recipient.
- Place a fraud alert or freeze your credit with the three major credit bureaus (Equifax, Experian, TransUnion) if you suspect your medical identity has been compromised.
- Use strong, unique passwords for all online healthcare portals and enable two-factor authentication whenever available to secure your accounts.
Real-World Examples
Sarah received a bill for an emergency room visit and an MRI scan from a hospital in a city she had never visited. Upon investigation, she discovered someone had used her insurance card and driver's license, stolen from her car, to receive treatment under her name.
Mark's health insurance claim for a routine check-up was denied because his annual benefits limit had already been reached. He later found that a scammer had used his identity to fill expensive prescriptions and undergo physical therapy sessions for several months.
An elderly couple, the Johnsons, started receiving collection calls for thousands of dollars in medical debt for durable medical equipment they never ordered. It turned out a 'friendly' visitor had convinced them to share their Medicare number, which was then used to fraudulently bill for wheelchairs and oxygen tanks.