Medical Identity Theft: The Hidden Threat That Can Corrupt Your Health Records

Medical identity theft occurs when someone uses your name and insurance information to receive medical care, prescription drugs, or medical equipment. Unlike financial identity theft, the consequences extend beyond money — fraudulent medical records can contain incorrect blood types, allergies, diagnoses, and medications that could lead to dangerous treatment decisions in an emergency.

Medical identity theft is often discovered in the worst possible circumstances: when a victim arrives at an emergency room and their records show a blood type or allergy that isn't theirs, or when they receive a bill for surgery they never had. The FTC estimates that medical identity theft affects hundreds of thousands of Americans annually, with healthcare data breaches exposing millions of records each year.

The most common sources: healthcare data breaches (hospital and insurance company databases are prime targets), insider theft by healthcare employees, and physical theft of insurance cards. Your health insurance card contains your member ID and group number — enough to receive care billed to your insurance. Treat it with the same care as your credit cards.

Proactive detection: review your Explanation of Benefits (EOB) statements from your insurer every time you receive one. An EOB for a procedure you didn't have is a clear sign of medical identity theft. Request your medical records from your healthcare providers annually and review them for unfamiliar entries. Under HIPAA, you have the right to access and correct your medical records.

If you discover medical identity theft, contact your health insurer's fraud department immediately, request a copy of your records from any provider listed in the fraudulent claims, and file a complaint with the FTC and your state's insurance commissioner. Correcting fraudulent medical records is a lengthy process — document everything and keep copies of all correspondence.