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How to Combat Medical ID Theft

Review doctor and health insurer notices to preempt the problem.

The Problem

A crook uses health insurance information to get medical care and prescription drugs in your name.

Scare Factor

Boats docked on Lake Champlain.

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Medical ID theft is hazardous not only to your finances—in the form of big bills and depleted insurance benefits—but also to your health. Mixed information in your medical files could be deadly if, say, you’re allergic to penicillin and someone who is using your identity tells a doctor that she isn’t.

How to Combat: Stolen Social Security Number | Tax Identity Fraud | Lost/Stolen Electronics | Hacked Credit/Debit Account

But rather than commit medical identity theft, thieves are more likely using the data compromised through recent health care breaches for more lucrative types of identity theft, such as filing fraudulent tax returns, says Eva Velasquez, president and CEO of the Identity Theft Resource Center.

How to Avoid It

Review all notices from doctors and your health insurer, including each explanation of benefits, to confirm that the treatments and services listed are ones you or your family members received. Also watch for bills for medical services you never used and for letters or calls from collection agencies attempting to reclaim debts a thief racked up in your name. If a health care provider mentions anything that seems amiss—say, a surgery you never had or an incorrect birth date—don’t brush it off as an innocent mistake.

What to Do If You’re a Victim

Medical identity theft can be complex and costly to clean up, with 65% of victims paying an average of $13,500 out of pocket in fraudulent bills and other expenses, according to the Ponemon Institute. It’s a time-suck, too: Victims who managed to resolve their problem spent an average of 200 hours working on it. If you think you’ve been hit, ask each of your medical providers (as well as those you suspect the thief used) for a copy of your records. Legally, they must provide the records, but you may have to pay a fee. Also request an “accounting of disclosures” that lists anyone to whom the provider has sent copies of your records.

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Write letters to the medical services, with copies of the records in error, to ask for corrections. Notify your health insurance company, and dispute any claims that aren't yours. Insurers aren't required to cover fraudulent claims, but many won't make you pay, says Ann Patterson, senior vice president of the Medical Identity Fraud Alliance. If a medical account in debt collection appears on your credit report, notify each bureau reporting it, and write a letter to the billing department of the medical provider as well as to the debt collector. File a police report, and send it as part of your correspondence.

How to Combat: Stolen Social Security Number | Tax Identity Fraud | Lost/Stolen Electronics | Hacked Credit/Debit Account

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