What is medical identity theft? + Prevention tips for 2024

How can medical identity theft occur?

Medical identity theft can happen to anyone, but people with health insurance or Medicare are the most common targets because thieves want to use this information to receive treatments for themselves or to submit claims they can be repaid for. While medical identity theft is rare compared to credit card theft (the FTC received 27,821 reports of medical identity theft compared to almost half a million reports of fraudulent new credit accounts), it’s still important to keep your eye on your medical accounts for signs of theft.

Many instances of medical identity theft occur in one of these three ways:

• Physical theft: One of the most common methods thieves use to steal your identity is through the physical theft of your insurance or Medicare information. These documents might be stolen by someone you know or by a stranger if your wallet is stolen or lost.
• Hackers: There have been a significant number of healthcare data breaches over the past 13 years—between 2009 and 2022, the U.S. Department of Health and Human Services Office for Civil Rights received more than 5,100 reports of data breaches. These breaches exposed more than 382.2 million medical records. Hackers can also get unprotected data by gaining unauthorized access to your own computer and devices.
• Social engineering: Social engineering is when an identity thief engages in phishing attempts to learn as much of your personally identifiable information as possible. They might call you and pretend to be from Medicare or your insurance provider, offering some new or discounted services. They’ll ask you to confirm details like your Social Security number or policy number before they can provide you with “coverage.” 

No matter how a thief tries to get your medical information, it can cause severe problems that can put your health (and financial security) at risk.

Medical identity theft consequences, costs, and risks

In addition to the cost to taxpayers—one estimate suggests there is almost $60 billion in Medicare fraud each year—one of the biggest problems of healthcare identity theft is that it’s often recognized too late. Many people don’t see the signs of identity theft until they receive a bill or get a call about the results of a test that wasn’t performed on them.

Because claims can take a while to process, you may not find out about fraud until the account has been sent to collections or you’re refused treatment because you’ve hit your benefit limits.

Another serious issue is the possibility of an incorrect diagnosis. If someone has stolen your identity and received medical treatments for specific conditions, the next time you see a doctor, they may make a diagnosis based on the other person’s medical history.

Signs of medical identity theft

Some major warning signs of identity theft related to your medical information include:

• Being billed for services you didn’t receive.
• Finding errors in your explanation of benefits (EOBs).
• Finding a medical debt collection notice on your credit report.
• Being denied coverage because your insurance company tells you you’ve reached your benefit limit.

Fortunately, there are resources that can help you report medical ID theft.

What to do if you’re a victim of medical identity theft

Finding out your personal information has been stolen can be scary, but it’s crucial to act swiftly. Here’s how to report medical identity theft and prevent further damage.

• Report the fraud to the Federal Trade Commission (FTC): Visit the IdentifyTheft.gov website and file a report. The FTC will help create a recovery plan to deal with the aftermath of your identity theft. 
• Report Medicare fraud to the Office of Inspector General: This office investigates fraud and waste related to programs run by the Department of Health and Human Services, including Medicare.
• Get copies of your medical records: Request medical records from your providers and any providers listed in claims through insurance or Medicare. Once you have the records, find every mistake so you can investigate them.
• Comb through your credit report: Your credit report will show if any new accounts have been opened in your name or if any medical accounts have been sent to collections.
• Contact the credit bureaus to set up a credit freeze or fraud alert: The credit bureaus can put a freeze or fraud alert on your credit report to prevent thieves from opening new accounts.
• Report identity theft to the police: Some insurance providers and debt collection agencies may require you to report identity theft to the police.

You don’t have to wait until you’ve had your identity stolen to take steps to protect yourself. Check out a few of the suggestions below.

7 tips to help prevent medical identity theft

Protecting yourself from identity theft is about paying attention to how and where you use your personally identifiable information.

1. Safeguard your medical documents: Keep your health insurance enrollment forms, health insurance cards, prescriptions, prescription bottles, billing statements from doctors or other medical providers, and explanation of benefits statements from your health insurance company in a safe place.
2. Be careful who you give your Medicare number to: Don’t give your Medicare number to anyone over the phone. Whenever you see a new provider, talk to them about how they handle your data and who can access it.
3. Don’t provide medical or personal info to people you don’t know: Unsolicited phone calls and text messages are some of the most common ways thieves will try to steal your medical information.
4. Safely dispose of sensitive documents: Shred or dispose of documents that contain any personally identifiable information with a service that handles sensitive data. For digital files, empty your trash often and use antivirus software like Norton 360 Deluxe to help reduce the risk of exposing your information. Norton 360 Deluxe offers protection from hackers and malware, and provides you with a VPN for safer internet use.
5. Keep an eye on your credit report: Check your credit report several times per year and look for any unpaid medical accounts, as they could be a sign of identity theft. Report any suspicious accounts or charges as soon as you can.
6. Check your insurance claims regularly: The EOB statements you receive from your insurance company will show all the claims submitted in your name. Look for any claims that didn’t come from your providers.
7. Sign up for identity theft protection: ​​Identity theft protection services help provide peace of mind by regularly scanning the internet for your personal information. LifeLock Standard scans the dark web and looks for suspicious uses of your data. It also offers reimbursement for monetary losses and legal and expert assistance to secure your identity.

Preventing identity theft can never be 100% effective, but you can reduce the odds of being targeted by limiting your exposure and acting fast when you notice someone is using your information without your knowledge or permission.

Get help with medical identity theft prevention

If your medical identity has been stolen, contacting and following up with every provider, insurance company, and financial institution can take a lot of time and effort. If you want an additional level of protection, consider LifeLock Standard, which is backed by a team of experienced professionals who can help secure your identity and repair any damage.

FAQs about medical identity theft

Still have questions about medical identity theft? We have answers.

How do you resolve medical identity theft?

Resolving medical identity theft can be complex. First, examine records and credit reports to look for fraudulent activity, then contact those providers for more information about the charges. After you have that information, report the fraud to the proper government authorities and the credit bureaus.

How can I find out who has accessed my medical records?

You will need to contact providers and insurers to find out who has accessed your medical records.

What information can be stolen from someone's medical records?

Names, addresses, phone numbers, credit card numbers, insurance policy information, Medicare numbers, health history, and prescriptions are all examples of information that can be stolen from your medical records.

How do you recover from medical identity theft?

Filing a report at IdentityTheft.gov is a good place to start. The FTC will work with you based on your unique circumstances to create a recovery plan and help you recover your identity.