Medical identity theft and health care fraud are serious crimes in the U.S. Much like getting your credit card number or name and address taken and used by someone else for their own benefit, having your “medical identity” stolen an abused has the same consequences in terms of financial burdens but it is a lot more serious in terms of your medical record being altered with someone else’s information.

Medical identity theft happens when someone uses your personal information to get money, prescription drugs, and medical care in your name. This type of identity theft creates a lot more than financial hardship, it changes your medical history and enters new diagnosis records and prescriptions that could end up endangering your own life.

Medicare fraud is basically the same thing, however this applies to medical benefits afforded to individuals by the federal or state governments and this can also have the same consequences in that if Medicare realizes that you have been using these benefits when you do not yet qualify for them you could be held liable. All a thief needs is your social security number to apply for these benefits.

Medical fraud can be committed by anyone who can’t otherwise afford to pay for any medical attention. The law does not require medical facilities or their personnel to be experts at verifying information that is rendered before they extend medical services, in most cases no verification process is in place to make sure that the person getting medical care is in fact who they say they are.

One of the reasons why your medical identity ends up in the wrong hands is because medical clinics and facilities do not really have strict security measures in place to protect your personal information. Medical insurance fraud is often the work of criminal rings that dupe or bribe clerks into volunteering this information, which is now in electronic form and much easier to transfer.

Why medical fraud is lucrative

The criminal rings that farm this information sell it for a profit, these types of operations make credit card fraud look like shoplifting candy. These are multi million dollar operations that cater to ex-cons, undocumented workers, and anyone who’s willing to pay for the information that can afford them medical care. Your information may also be traded via online financial black markets.

The consequences of health care fraud and abuse

To begin with, you could end up being canceled or suspended by your health insurance carrier once they detect that your account is at risk of fraud. Your diagnosis records change permanently and in most cases it is basically impossible to correct the entries, and this can pose a serious danger to your life if you’re given the wrong diagnosis when you seek treatment. You could also end up with a medical bill for which you never actually received treatment but are expected to pay in full. This would typically happen if your health insurance does not cover the treatment that the thief got or if your benefits were exhausted in the process.

How to protect against medical identity theft

• Only share your health insurance information with trusted sources.
• Be aware that phishing scams may also target you for your medical insurance information.
• Monitor and read your explanation of benefits from your health care provider and get quarterly summaries from your carrier that describe all the benefits you have used so far and detect any discrepancies.
• Keep copies of your medical records in case you need to prove something in a dispute.
• Check your credit report often, if there are any medical leans against you, they would be recorded there.

Your medical records are in many different places especially if you’re older and have a long medical history. So it would be very impractical to try and monitor each of the sources that have your information especially if you have had several health insurance carriers throughout your life. There are only a handful of identity theft prevention services that can monitor your health insurance benefits and protect your identity from medical identity theft, Trusted ID is one of them. Outside of outsourcing and automating the process through identity theft protection services, there isn’t much on the individual level that you can do to make sure your medical information remains filed safely.

The point of employing these services is so that the responsibility of monitoring and verification of your information is passed to an entity that is technologically equipped to detect and stop unauthorized medical transactions from taking place in your name. Fraud prevention services have evolved quickly bringing forth a lot of great security features due to the dire need to monitor medical records and prevent health care fraud and abuse from occurring to hard working individuals.