Medical Identity Theft

Medical identity theft occurs when someone uses another person's name and health insurance details to access healthcare services, obtain prescription medications, file insurance claims, or receive medical equipment. Unlike financial identity theft, which primarily causes monetary harm, medical identity theft can also corrupt a victim's medical records — adding incorrect diagnoses, medications, or treatment history that could endanger the victim's future healthcare.

The fraud is often discovered when a victim receives bills for services they never received, when an explanation-of-benefits statement shows claims they did not file, or when a healthcare provider flags a discrepancy between a patient's stated history and their records. Correcting a corrupted medical record is notoriously difficult: healthcare providers may be reluctant to share records without confirming identity, and there is no equivalent to a credit freeze for medical data.

Risk factors include sharing insurance card details, compromised healthcare provider data systems (which are frequent breach targets), and the buying and selling of healthcare data on dark web markets. Patients should regularly review their insurance explanation-of-benefits statements, request copies of their medical records periodically, and report discrepancies to both their insurer and healthcare provider promptly.