Medical Identity Theft

Medical identity theft is scary and more common than you think.

Medical Identity Theft

All types of identity theft are a pain, but none more so than medical identity theft. If a criminal steals your personal information for their medical use, it could mean not only that your credit gets ruined, but also that your life is threatened by false medical records. That’s a worst-case scenario. Yet, it doesn’t hurt to be prepared, especially since medical identity theft is becoming more common. A study in the Journal of the American Medical Association showed that between 2010 and 2017, the number of medical ID theft cases rose almost every single year.

What is medical identity theft?

Medical identity theft occurs when someone uses your personal info for medical care or medical insurance claims. This can seriously harm your credit, alter your personal medical records, mess up your insurance policy, and cause you major embarrassment. It can also lead to higher out-of-pocket costs for the medical procedures that you need.

Medical identity theft statistics:

  • 27% of data breaches were related to medical records in 2017.
  • 65% of victims needed almost $13,500 to pay off fraudulent bills.
  • Of victims studied, 3% lost their jobs.
  • 23% purposely gave their healthcare info to someone they knew to help them out.
  • Family members committed 24% of medical identity theft without their family’s knowledge.
  • Only 10% of victims were completely satisfied with how their situation resolved.
  • 30% of victims had no idea when the identity theft occurred.

How does medical identity theft happen?

For this type of identity theft to occur, thieves need access to your personal info. These are just a few of the ways they can steal your information for medical identity theft:

Physical records or insurance cards

For the most part, people are very careful with their medical and insurance records. Unfortunately, when patients or their healthcare providers are negligent, thieves can steal personally identifying medical info.

Electronic Health Records (EHRs)

Almost every healthcare worker in a hospital can access patient records. If any of them have ill-intent, they could simply take your records while they work.

Data breaches

Large medical databases are susceptible to hackers. Criminals have good reasons to target medical records, too – they fetch a high price on the black market. Through various methods of online identity theft, thieves will break into secure databases and steal thousands of records.

How to know if you are a victim of medical identity theft

If someone stole your medical information, find out as soon as possible. Keep an eye out for these signs:

Bills for medical services you didn’t receive

If a bill shows up in your mailbox for a medical service you never actually received, then someone may have used your insurance for their own medical care.

Incorrect info on your Electronic Health Record (EHR)

Your doctor keeps an EHR with all of your health information on it. If the doctor mentions something on the EHR that you know is wrong, it’s possible someone used your insurance for their own treatment.

Maxed out policy that doesn’t make sense

Say you’ve only had a few medical appointments this year. Then you get a call from your insurance company saying that your plan is maxed out! Before you blame the company, find out if someone else used your plan.

Calls about medical debt you don’t owe

If you receive a call about paying your medical debt when you know you don’t owe any medical debt, an identity thief may have gotten procedures in your name.

Unfamiliar collection notice on your credit report

In the same vein as collection calls, a collection notice on your credit report for a medical debt you never incurred is a sign of medical identity theft.

Denial of insurance because of a condition you don’t have

When you try to get insurance, companies will review any preexisting conditions. If you are denied because of a disease or condition you aren’t afflicted with, an identity thief could have used your name for coverage.

Medical identity theft cases

Just in case you needed solid evidence of how bad medical ID theft really is, here are some stories that made the news:

Drugs on someone else’s dime

In 2008, someone stole Deborah Ford’s purse. In 2010, she heard about a warrant out for her arrest for something she had never done. Someone used Ford’s info for fake prescriptions to get 1,710 codeine and hydrocodone pills. The charge was on Ford’s record for 5 years.

A liver transplant on a different policy

Amira Avendano-Hernandez couldn’t afford a new kidney. She decided to buy someone’s SSN on the black market and get it anyway. The victim had no idea that her identity was being used by someone else until she was contacted by authorities.

The baby that wasn’t hers

A baby was born in a Utah hospital and tested positive for methamphetamine, alerting Child Protective Services. CPS contacted Anndorie Cromar, mother of four. They told her they knew about her drug addiction and all four of her kids – plus this new baby – were in danger. Cromar hadn’t given birth in years. Finally, she found out that the drug-addicted mother had used her stolen driver’s license to commit medical identity theft.

Bad credit, worse allergies

Ronnie Bogle is allergic to penicillin. His brother Gary, who stole Ronnie’s medical identity, is not. If he required emergency treatment and was treated with Gary’s info on his record, penicillin could have killed him. Luckily, this didn’t happen. But Ronnie is still fighting over his records with multiple hospitals.

Blood donation denial

Nikki Gordon wanted to donate blood at her high school’s blood drive. Turns out, the 17-year-old couldn’t donate because her records said she tested positive for AIDS. Gordon was positive this was false. After her initial surprise, she discovered that someone in California was using her Social Security number for medical treatment.

How to prevent medical identity theft

There are (fortunately) plenty of ways to keep your medical information safe from identity thieves. Start using these tactics to safeguard your identity:

Check Explanation of Benefits/Medicare Summary Notice

Medical insurance providers send out forms that outline what treatments they paid for in the last year. Discrepancies between your own records and these forms could be mistakes, but may alert you to identity theft.

Correct errors in medical records

If you find errors in your records, your next step is to send mail about the errors to both your doctors and your insurance provider. The Federal Trade Commission (FTC) has a succinct guide to correcting medical record errors on their medical identity theft page.

Protect your SSN and medical insurance info

Keep your personal information safe. Both your Social Security number and your insurance information can be used for medical identity theft.  

Ask for a replacement number if you lose your card

Instead of just asking for a new card, ask for a new number as well. Someone could be using your lost card, and things will get messy if you keep the same number.

Shred medical documents before disposal

Treat your medical documents no differently than your other confidential papers. If you’re throwing some documents out, also shred them beforehand.

Keep your own records

Your healthcare providers keep records of your visits and procedures. Do you? Start taking notes on your medical care. Then if something is wrong on your records in the future, you will have something to compare it to.

Don’t give your information over the phone

Medicare will never call you. Keep your information safe and don’t share it on the phone.  

Responding to medical identity theft

Hopefully you never experience the nightmare that is medical ID theft. For those unlucky patients, here are five things you can do after you discover you’re a victim:

Contact your insurance provider

When you notice a sign of medical fraud, the first thing you should do is call your insurance provider. If the sign you noticed was actually a mistake by your provider, then calling them will help you find out.

Request copies of your records

Ask for records from the places where the medical fraud may have occurred. You will need all of the evidence you can get.

Get an accounting of disclosures

An “accounting of disclosures” tells you who received your medical records from your healthcare provider. You get one free accounting of disclosures per provider per year. This will show you the places that got your fraudulent records.

Report it on

Once you’ve confirmed that someone else is using your medical info, go to to report it. This website, created by the FTC, will generate a recovery plan for you.

File a police report

Only 40% of medical fraud victims reported the identity theft to law enforcement. Even if you’re not sure it will help, file a report for your own safety.

Article last modified on February 25, 2019. Published by, LLC .