Medical Identity Theft – A Closer Look

Health headlines have been front and center over the last year. A focus on staying healthy and fit has been highlighted by the pandemic, as has a constant reminder that access to good healthcare is always crucial for everything from standard checkups to serious emergencies. This access is an in-demand commodity, and with that comes the potential for scams and fraud.

We have examined some scams, such as the ACA open enrollment, specific to the healthcare industry in previous posts. Still, a similar ongoing threat broader in scope is now in the spotlight – medical identity theft.

Understanding Medical Identity Theft

Medical identity theft is not as commonly discussed or publicized as are more financially focused forms of fraud. And although it may not generate as much attention, the ramifications can be more difficult to remedy while also resulting in higher overall costs to the victim. Financial identity theft can often be restored with minimal costs, and long-lasting impacts can be limited. Medical identity theft poses a more serious issue with an increased potential of long-term impact and financial burden.

A study in recent years by the Ponemon Institute found that the average cost of an instance of medical identity theft was $13,500 for 65% of victims. The same study states that there were 2.3 million victims of this type of fraud in 2015, a number that has been on the rise in the five years since these figures were released. The total estimated annual economic impact from these sits at a whopping $41 billion.

What makes things even more alarming is the reality that individual victims are often left to deal with the financial issues that arise in the form of legal bills and incorrectly attributed medical bills created by an occurrence of medical identity theft. Banks and other financial institutions will commonly foot the bill for credit card and financial fraud; insurance agencies and healthcare providers will not.

What is Medical Identity Theft?

According to the FTC, “medical identity theft is when someone uses your personal information – like your name, Social Security number, health insurance account number or Medicare number – to see a doctor, get prescription drugs, buy medical devices, submit claims with your insurance provider, or get other medical care.”

In short, instead of a fraudster stealing your money outright, they steal your access to health services. This has obvious financial impacts in terms of the cost of these services, but it can also result in a loss of coverage if unknown bills are not paid. The fallout from the crime can also affect your credit score.

What You Can do to Limit the Risk

As with many types of identity fraud, protecting your personal information is key to limiting the risk of its being stolen and used without your knowledge. Any physical or digital records you have from your healthcare provider or doctor should be kept safe and confidential. Health record information may not seem as valuable as your bank statements and personal passwords, but access to this information is all that thieves need in order for them to use it to their benefit.

Treat your health insurance card like a credit card in terms of not sharing the information it displays with others or leaving it in plain sight in public. You may want to consider removing the insurance card from your wallet outright and using a digital version on your smartphone instead.

Billing statements, enrollment forms, and Explanation of Benefits statements are other documents that contain your personal information and should be protected. Rip up or shred these documents before throwing them in the garbage, and don’t leave them sitting in your mailbox if you still get paper statements and bills. Prescriptions and pill bottles can also be stolen to gain access to your health information. The thought of thieves rummaging through your trash for this seems old-school and unsettling, but it still happens.

You should also be reluctant and hesitant to reveal your personal information for healthcare purposes. Although doctors’ offices may request your Social Security number as a form of identification, instead, ask them if you can use a different form of ID or only use the last 4 digits of your SSN. If someone asks for your health insurance number or other questions about your health, make sure they are a trusted source and still be diligent in giving it out. It’s always recommended to ask why this information is needed and how it is being protected from compromise if it is required for any official reason.

Scams and Signs to Look Out For

Typical scammer tactics exist with medical identity theft in mind. Never give out your medical information unsolicited, and always be hesitant even if the request seems official. If you receive a phone call, email, or text from a supposed healthcare provider randomly asking for this information, there is a likely chance that it’s a scam. You can contact your provider directly through their official website or via phone to see if they really need this information.

Even if you protect your information carefully, there is still a chance of someone gaining access to and using it for medical ID fraud. Some signs to look out for that indicate your information is being used without your knowledge include:

  • Calls from debt collectors about an undue medical bill or debt
  • Doctor’s or health care provider bill for a service that you did not receive
  • Unrecognized medical debt collection notices on your credit report
  • Obvious errors in Explanation of Benefits statement for services or prescriptions
  • Notice of health benefit limits being reach without having used health services

If you fall victim to medical identity theft, it’s important to take quick action to rectify the issue. Obtain all medical records that you think are false and inform the location (doctor’s office, hospital, etc.) of a suspected identity theft issue. Report any errors, mistakes, or unknown bills immediately to your health care provider. Keep a steady eye on your credit reports for medical debts, and promptly report any errors or suspect notices.

Medical identity theft is an ongoing issue that can have a severe and lasting impact on its victims. Identifying the fraud quickly and working towards recovering is crucial in order to limit its effects.

LibertyID provides expert, full service, fully managed identity theft restoration to individuals, couples, extended families* and businesses. LibertyID has a 100% success rate in resolving all forms of identity fraud on behalf of our subscribers.

*LibertyID defines an extended family as: you, your spouse/partner, your parents and parents-in-law, and your children under the age of 25.