Medical Identity Theft: How to Protect Yourself

By: James Harrison October 15, 2019
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Your medical information is a goldmine for cyber criminals and fraudsters. Unfortunately, medical identity theft affects millions of Americans every year, and it can wreak havoc on your finances and even your health.

What is Medical ID Theft?

Medical identity theft happens when someone steals your personal information, electronic health records or insurance information and uses it to get medical treatment, equipment and prescription drugs in your name. This could leave you footing the medical bills and even mixing their health records with yours. In fact, according to a recent study from the Ponemon Institute, medical ID theft victims spend nearly $13,500 on average to deal with the problem, including paying off fraudulent medical bills.

With continual cyber-attacks and data breaches among both healthcare providers and health insurers, medical identity theft will most certainly claim millions more victims. Here’s what you need to know to protect yourself and your loved ones.

The Real Dangers of Medical ID Theft

Victims of medical identity theft have similar outcomes to other types of identity theft, such as ruined credit, but can suffer even more devastating consequences. Victims can have medical insurance claims denied, lose access to their insurance, and be forced to pay to restore their insurance coverage. If thieves max out benefit thresholds on an insurance policy, policyholders could find themselves unable to get timely coverage for urgent treatments.

Victims might see the cost of their insurance increase or may be denied coverage altogether if the fraudulent treatment included care for things like diabetes, osteoarthritis, or cancer. They may be unable to access their own medical records. ID theft victims could end up with a flag in the system triggering regulators or even law enforcement to track them down over charges they’d illegally purchased prescription drugs.

When medical identity theft results in erroneous medical records, the consequences can even be life threatening. Drug allergy warnings or other special medical conditions may be deleted. Previous medical procedures can be erased. Blood types can be changed in the patient’s medical records, endangering the life of the ID theft victim should they need a blood transfusion. These potential health risks alone are reason enough for consumers to be vigilant and get protected.

Of course, the theft of medical records also gives thieves access to your other personal and financial information including Social Security number, date of birth, and bank or credit accounts. Victims of medical identity fraud often find themselves also fighting other types of identity theft including credit fraud, Social Security fraud, tax return fraud and more.

Look Out for Red Flags

There’s a lot you can do to keep an eye out for signs of medical identity theft. Here are a few red flags you should watch for:

  • A bill for medical services or equipment you don’t recognize
  • Double billing charges on a medical bill
  • Mistakes on your medical history
  • A call from a collection agency about a medical bill you don’t owe
  • Denial of insurance due to a medical condition you don’t have
  • A letter from your health insurer notifying that you have reached your benefit limit

Friendly Fraud

While many thieves obtain the victim’s medical information in the typical pattern of hacking, phishing, stealing mail or copying your records at a clinic or other facility, about half of all medical identity theft happens among family members.

The Ponemon study revealed that 24% of medical identity theft victims said a family member took their medical credentials and used them without permission. Another 23% said they willingly shared their health insurance information to help a family member or friend obtain medical care.

In the study, most of the people who shared medical info did not consider it a crime, but it’s still considered fraud against medical insurers and health care providers. Sharing Medicare or Medicaid information with someone else to help them obtain coverage is also a state and federal crime.

5 Tips for Protecting Yourself

While it can be difficult to protect your information from being exposed in a data breach, there are ways to lower your risk.

  1. Ask about security practices. Inquire how your doctor’s office, hospital and insurance company protect your personal information. They are required to safeguard your data – and you have the right encourage privacy by asking how they protect you.
  2. Secure your copies. Store any paper and electronic copies of your medical and health insurance records in a safe place. Shred or burn health forms, insurance and prescription papers.
  3. Be suspicious. Don’t fall for online or phone scams for things like “free” medical quotes, products or services. Don’t share personal or medical information online or over the phone unless you initiate the conversation.
  4. Review your medical records. Carefully read through your insurance statements and medical records for anything you don’t recognize.
  5. Monitor for ID theft. Many medical ID theft cases are first detected with identity theft and credit monitoring where you’ll be notified of collection notices for unpaid medical bills and other signs of ID theft.

Get Expert Help

If you know that your medical identity has been stolen, you can start taking steps on your own to work through it. Those steps can include requesting copies of your medical records, which might require paying a fee, and asking medical providers to correct false information. The Federal Trade Commission offers a helpful checklist of steps to take when working through medical identity theft on your own.

However, expert help is available to monitor for medical identity theft – and recover from it with minimal damages and downtime. You may choose to enroll in a trusted identity theft protection plan to help monitor for suspicious activity, including medical ID theft. These plans also include professional recovery and restoration services to rely on in the event you ever suspect you might have a medical ID theft problem.

Keeping watch over your medical information, credit report, financial statements and insurance statements may not prevent all cases of medical identity theft, but staying vigilant and proactively monitoring for problems can help you notice fraud faster and take action quickly to correct it.