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Medical Identity Theft


Identity theft is a term commonly associated with financial transactions, but did you know it can also happen with medical and pharmaceutical information?
Medical identity theft is “the use of a patient’s personally identifiable information to obtain medical treatment, services, or goods.”²

This form of theft is hard to detect and may go unnoticed for long periods of time. It may also be more difficult and costly to resolve than financial identity theft. It’s important to understand the warning signs to know if you might be a victim.

Detecting Medical Identity Theft

If you are a target of health care fraud, you may experience any or all of these circumstances:

  • Receive a bill for medical services you do not recognize
  • Get denied for insurance or coverage of a specific treatment because your records show a medical condition you do not have
  • Receive a notice from your health plan that you reached your benefit limit
  • Hear from a debt collector about medical debt you were unaware of

Reporting the Problem

Once you have established you are a victim of medical identity theft, it is crucial to take action right away:

  • Call your insurance company, all three credit reporting agencies and the appropriate authorities immediately
  • Obtain copies of your medical records and highlight any discrepancies

In 2016, 27 million medical records were breached, nine times more than financial records.1

  • Contact your health care providers and ask them to correct the false information
  • Place a fraud alert or freeze on your credit report

Protecting Your Information

  • Carefully review every Explanation of Benefits document you receive for suspect billings
  • Only provide your insurance information to legitimate sources
  • Purchase high-quality virus protection software for your personal computer and do not access health records from public wi-fi
  • Log on to your pharmacy benefit manager’s website and review your profile for accuracy


  1. Lord, Robert. “The Real Threat Of Identity Theft Is In Your Medical Records, Not Credit Cards.” Forbes, Forbes Magazine, 15 Dec. 2017
  2. Geaghan, Sharon. “Preventing Medical Identity Theft.” AACC, 1 Apr. 2017


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