What is Medical Identity Theft?

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  • Written By: wiseGEEK Writer
  • Edited By: O. Wallace
  • Last Modified Date: 09 September 2018
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Medical identity theft is a very serious problem in the modern world. As of the mid-2000s it accounted for approximately 3% of identity theft cases, and there is evidence that this percentage will grow. Essentially, it can mean one of several ways in which thieves exploit another person’s identity. These include using a person’s identity to file false claims to get money, using a person’s insurance and name to get medical care, or using a person’s identity to buy medical insurance and rack up bills.

One of the concerns about medical identity theft is that many medical records may now be stored online where they are more vulnerable to theft. Some US states have passed laws that require any agency that stores records to inform customers if their records were at any time insecure or accessed by any other than permitted personnel. This may help people be more vigilant and at least they can find out early when a problem exists.

In one type of theft, unscrupulous medical personnel steal records from their place of work. In this form of medical identity theft they might bill patients for procedures they never had as a way of generating income. Alternately, they could sell information like health insurance member numbers and social security numbers to others who need medical care.


Sometimes medical identity theft is much more direct. A person could steal a wallet and use a medical card to get medical care. Since such care is usually associated with things like copayments, theft victims might only find out when they receive bills from hospitals or doctors they don’t use. To prevent this, stolen health insurance cards should be reported as stolen.

Perhaps the most serious outcome of medical identity theft is that it may create life-threatening situations. Since any medical care can become part of each patient’s file, there could be inaccurate information in the file that could be disastrous. A wrong blood type, failure to note an allergy, assumption of conditions a person doesn’t have could mean that especially in an emergency, the person whose identity was stolen could receive care that is completely unsuited to him or her. This might result in a severe outcome, such as a dangerous reaction to a medication or to transfused blood.

The other issue for most people who are the victims of medical identity fraud is that this can cost a lot of money and take a great deal of time to resolve. It’s best to catch these things early, but people may not know where to look. It can often be assumed that a thief won’t use the same doctors, hospitals or pharmacies as the theft victim, so people may be unaware that theft has occurred, especially if a new health insurance policy is taken out in the person’s name.

The best bet, though, is usually to check any reports that originate from an insurance company. Be certain any claims or mailings from insurance companies are accurate. Contact the health insurance company immediately if there are discrepancies or problems with a report. Similarly, checking credit reports once yearly is a good way to determine if any unauthorized charges exist, but also check the mailbox. When people are charged for something they didn’t authorize, they may start receiving bills at home.

Many sources also recommend maintaining a copy of health records. These can get huge over time, and people may have to pay for any copies of them. Since there are now some companies that keep records online, it may be easier to access these, and to do so at little to no expense. These aren’t likely to contain all records, but they may contain several years’ worth.

If a person has been the victim of medical identity theft, it may be difficult to get the records of the thief out of personal health records. It’s thus a good idea to have a back up copy of records to share in cases of surgery or emergencies so doctors don’t take a life-threatening wrong action. People planning medical treatments, especially in hospitals should also share with their treating doctors that they were victims of medical identity theft, and this is why they are providing a private set of records. They may want to detail any inaccuracies found in their official records too, in case these are accidentally used to make treatment decisions.



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