Medical identity theft occurs when someone uses your name or insurance information to obtain medical care, prescription drugs, or file fraudulent insurance claims. It's one of the most difficult forms of identity theft to resolve.

Why Medical Identity Theft Is Especially Dangerous

  • False medical records can affect your actual healthcare — wrong blood type, allergies, or conditions on file.
  • Your insurance benefits can be exhausted, leaving you uninsured when you need it most.
  • It takes an average of 3 years to fully resolve, compared to 6 months for financial identity theft.
  • HIPAA privacy laws can actually make it harder to clear fraudulent records.

Warning Signs

  • Medical bills for treatments you never received.
  • Your health insurer denies a legitimate claim because benefits were already used.
  • Unfamiliar providers or prescriptions on your Explanation of Benefits (EOB).
  • A collections notice for a medical debt you don't recognize.
  • The IRS says someone else claimed your medical expenses as a tax deduction.

What to Do If You're a Victim

  1. Request your medical records from every provider you've used and your insurer's records of all claims filed in your name.
  2. File a complaint with the FTC at IdentityTheft.gov.
  3. File a police report — you'll need this to dispute fraudulent medical debts.
  4. Contact your insurer's fraud department and request a corrected Explanation of Benefits.
  5. Request corrections to your medical records in writing under HIPAA.

Prevention

Review every Explanation of Benefits statement you receive — don't discard them. Set up online access to your insurer's portal. Never share your insurance card freely. Shred documents containing your member ID.

Sources: FTC; Medical Identity Fraud Alliance (MIFA); HIPAA.gov.