Knowing the signs of medical identity theft can keep you from becoming a victim.

3 minute read

In 2021, the Federal Trade Commission (FTC) received more than 63,000 reports of health care fraud totaling $17 million. One type of health care fraud is Medical identity theft, which is when thieves use your health insurance or Medicare number to receive medical treatments, prescriptions and other health plan benefits under your name.

Medical identity theft doesn’t just potentially hurt your credit. When someone else uses your health plan benefits — maybe even making enough claims to use up your maximum benefit — your insurance carrier could deny medical coverage when you need it most.

That’s why you should always be on the lookout for signs of medical identity theft. Once you know what to look for, you can stop and report medical identity theft to your health insurance provider, doctors and the proper authorities.

Below are five signs that an identity thief may be cashing in on your medical identity.

1. Bills or claims for services not received

If you receive a bill from a doctor’s office or hospital for services never received, the charges could signal that someone else is using your health insurance ID number for their own medical needs. The same goes for the explanation of benefits (EOB) that your health insurance company sends for each claim.

Always review bills and EOBs carefully. If you see unfamiliar services, contact your health insurance provider to remove those claims and investigate further.

Find out: How to Understand Charges on Hospital and Doctor Bills

2. Unfamiliar medical debts on your credit report

One reason to review your credit report at least a few times a year is to spot unfamiliar accounts that could signal identity theft. It’s not just new credit card accounts to watch for, however. Unpaid medical debts show up, too.

Find out: Do Medical Bills Affect Your Credit Report?

3. Collection notices or calls from collection agencies

If you receive collection notices for past-due medical bills for services you never received in the mail, take action immediately. Call the collection agency or billing department and notify them that the debt isn’t yours and take steps to dispute the debt.

Find out: Facing Medical Debt Collectors? Here’s What You Can Do

4. You’re denied coverage for a pre-existing condition you don’t have

If your health plan provider notifies you that you’re not covered for a medical service or procedure because you have a pre-existing condition, that’s always bad news. But when the pre-existing condition used to deny coverage has nothing to do with your medical history, that’s even worse.

Being denied coverage for a pre-existing condition you don’t have is a sign that someone else could be using your health insurance or Medicare ID for medical services you know nothing about.

Find out: Take These 5 Steps to Check Your Medical Bills for Errors

5. You get a notice that you’ve reached your benefit limit

If your health insurance provider sends a notice that you’re no longer covered because you’re reached your benefit limit (when you should be nowhere near that limit,” that’s a sign that someone else has been receiving medical care at your expense, says the FTC.

Find out: 5 Strategies to Minimize Health Insurance and Medical Costs

How to protect yourself from medical identity theft

To protect your medical information from being stolen, take these steps:

Keep medical records in a secure place

Store all health insurance and medical records in a safe place. When you no longer need them, shred the documents rather than recycling or throwing away.

Limit mail correspondence

Limit the amount of medical information you receive in the mail. Access health insurance and Medicare claims, EOBs, medical bills and other medical or insurance information online instead.

Be discerning about providing medical information

If your doctor’s office asks for your Social Security number, ask if they can use only the last four digits instead. If another entity asks you to provide your health insurance or ID number, ask them why they need it, how they’ll protect the information and how they’ll use it.

Don’t provide medical information to unsolicited texts or emails

If you receive an unsolicited text or email message asking for your health insurance or Medicare number or other sensitive, personal information, don’t provide it. “Instead, log in to your online medical account from a website you know is real,” says the FTC. “Or contact the company or provider using a phone number you know is real.”

Review your credit report regularly

Request a copy of your credit report at AnnualCreditReport.com to watch for unfamiliar accounts. Sign up for a free credit report service such as Credit Karma for year-round access to your credit reports.

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

If you’re a victim of medical identity theft, request copies of your medical records from health care providers so you can review them for unfamiliar medical services or procedures someone else received under your name.

Report medical identity theft to the FTC’s IdentityTheft.gov. When you fill out your complaint, the FTC will use the information to provide you with an identity theft recovery plan.

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About the Author

Deb Hipp

Deb Hipp

Deb Hipp is a full-time freelance writer based in Kansas City, Mo. Deb went from being unable to get approved for a credit card or loan 20 years ago to having excellent credit today and becoming a homeowner. Deb learned her lessons about money the hard way. Now she wants to share them to help you pay down debt, fix your credit and quit being broke all the time. Deb's personal finance and credit articles have been published at Credit Karma and The Huffington Post.

Published by Debt.com, LLC