How to Prevent Medical Identity Theft

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Medical identity theft is a type of fraud you might not think of often, but it can have serious financial and even health consequences. Preventing medical identity theft can require keeping your information safe and quickly correcting mistakes in your medical records. As with other forms of identity theft, dealing with medical identity theft can be a headache. And, as with many medical ailments, prevention is often the best approach.

What Is Medical Identity Theft?

Medical identity theft refers to a form of identity theft that occurs when someone uses your name, Social Security number, health insurance number and other personally identifiable information (PII) to receive medical services or purchase medical products. Medical identity theft can look like:

  • Someone using your PII to get medical procedures, such as surgeries or tests, and having the bill sent to you or your insurance provider.
  • Someone using your PII to purchase prescriptions or medical equipment.
  • A health care provider using consumers' PII to file fraudulent insurance claims.

As with non-medical identity theft, dealing with the repercussions can be a confusing, time-consuming and costly process. But medical identity theft can also be more dangerous than other forms of identity fraud because it can lead to errors in your medical records.

It's not hard to imagine the mistakes that can happen when someone is rushed to the emergency room and their medical record has an incorrect blood type listed or doesn't show the correct allergies. Victims may also find they're denied coverage or treatments due to the fraud. In some cases, police have even issued arrest warrants for the victims because the identity thief used their information to purchase large quantities of prescription medications.

How Does Medical Identity Theft Happen?

Medical identity theft can happen when someone physically steals your information, such as your wallet with your health insurance card in it or medical records that you threw out. The thief often isn't a random person.

According to a 2015 study by the Ponemon Institute, about half the time, medical identity theft occurs between family members. Most often, this is done without the person's knowledge. However, 23% of people said they knowingly shared their medical information with a friend or family member—a type of "friendly fraud" that can still lead to mixed up medical records.

Medical identity theft can also happen when hackers steal information from health insurance companies and medical providers. In fact, medical records can be a juicer target than financial accounts. In 2017, Experian found that credit and debit card information could be sold on the dark web for up to $110 per account. At the same time, medical records were going for up to $1,000, depending on how complete the records were and whether it was a single record or entire database.

How to Protect Yourself From Identity Theft

While there's no way to keep all your information completely secure, there are steps you can take to help avoid medical identity theft and make recovery easier:

  • Read and review notices from your health plan provider, doctors, labs and pharmacies for unusual activity.
  • Ask for a new card and health insurance identification number if your information is lost or stolen.
  • Don't share your personal or health plan information with other people or with companies that claim to offer free services or products.
  • Never share your information on the phone or via email unless you initiate the conversation or can verify that the person contacting you isn't a fraudster.
  • Shred old documents that have your personal information on them.
  • Monitor your credit, as unpaid bills may eventually wind up in collections under your name and hurt your credit.
  • Check your medical records at least once a year.
  • Keep copies of your medical records as proof of your correct information.

You'll also want to implement the same practices you might already use to avoid other types of identity theft, such as using strong and unique passwords for your online medical accounts.

What to Do if You Think You're a Victim of Medical Identity Theft

If you receive a bill for a service you didn't receive, notice an error in your medical records or suspect you've been a victim of medical identity theft for a different reason, here's where you'll want to start:

  • Report the identity theft to the Federal Trade Commission to get your identity theft report and recovery plan. In some cases, you may also want to file a police report.
  • Consider freezing your credit or adding a fraud alert to your credit reports.
  • Request your medical records (you may have to pay for copies) and contact your medical providers if you need to make corrections. You may want to send an explanation of what happened, copies of the inaccurate records with the errors circled, a copy of your identity theft or police report, and supporting evidence.

The process can be difficult, particularly if you have to deal with multiple medical providers, insurance companies and debt collectors.

Monitor Your Information and Stay Protected

Unlike financial fraud, which you might detect right away, it can be weeks or months before you realize that someone has used your medical plan. You might receive free credit monitoring if your information is stolen in a data breach, but that's not going to help you get everything fixed—and you can sign up for free credit monitoring on your own anyway.

As an added protection, a service like Experian's identity theft and credit protection service includes credit and dark web monitoring to help notify when something is amiss. If someone steals your identity (medical or otherwise), you can receive fraud resolution support and get up to $1 million in identity theft insurance to help cover legal fees and other costs associated with getting your identity and medical records fixed.