Imagine that you see a curious charge on a bill from your doctor. Or your pharmacist says your new prescription conflicts with another drug your records show you take. But you aren’t taking that drug.


You could be the victim of medical identity theft. This kind of fraud occurs when someone steals your personal information and uses it to get health care or medical products. The phony claims put all the information in your medical records at risk and may affect your ability to get the care you need.

Unfortunately, medical identity theft is a growing problem. According to the Medical Identity Fraud Alliance, over 1.8 million Americans were victims in 2013, up 19 percent from 2012. In 2014, there were almost 500,000 more victims than in 2013. And the number of victims who wind up paying out-of-pocket costs to fix the problem is rising, too. 

Theft often occurs in health care facilities, where workers sell data. But the culprit is also often a friend or family member, the alliance said. The group offers safety tips for consumers.

4 Ways to Detect Medical Identity Theft

If you suspect someone has stolen your medical identity, take these steps:

  1. Look over all of your Explanation of Benefits (EOB) statements — even if you owe nothing. If anything seems wrong, call the number on the EOB or on the back of your member ID card. You should also call if you do not get an EOB statement after you receive care. Someone could have changed your mailing or email address to avoid detection.
  2. At least once a year, look at a list of your medical claims. If you find a claim for care you didn’t receive, call the number on your ID card.
  3. Consider checking your credit reports for suspicious medical debts. You can get a free credit report every year from each of the three leading consumer reporting companies. Call 877-322-8228 or visit to find out more.
  4. You can ask your health care providers for copies of your medical files.

Protecting Your Medical Identity

Protecting your health plan ID card and the data printed on it is one of the most important things you can do to avoid becoming a victim of medical identify theft.

You should also treat medical bills, prescription drug labels and health plan records as you would treat any other important information. Store them in a safe place and shred anything you throw away.

To keep your medical identity to yourself, it’s your right to:

  • Learn where your providers have sent your medical information. For example, if you move, your records may have gone to new doctors or hospitals.
  • Ask your health care providers how they use your information.
  • Get wrong or incomplete information removed from your files.
  • Have correct information added to your files.

Today, more and more personal health information makes its way on to the internet. So remember to keep your date of birth, Social Security number and other data to yourself. Share your private medical information only with your health care providers.

Staying Safe

Identity thieves use many tricks to get your medical and health insurance information. But you can make that hard to do. Here are a few strategies that can help:

  • Be wary of anyone who offers you a free health service, test or product but asks for your health insurance ID number.
  • If you’re contacted by phone or email, verify the identity of someone who says they work for your doctor’s office or health plan.
  • Don’t share information by phone or email unless you started the contact and you are sure you know who you are dealing with.
  • Keep all your records in a safe place.
  • Be careful online. Look for the lock icon on your internet browser’s status bar. Or check that the website’s address starts with “https” — the “s” is for secure.

Learn more from the Federal Trade Commission. And find out your rights under federal privacy laws on the Department of Health and Human Services website.


Call the fraud hotline.

If you suspect fraud, don’t hesitate to call the Blue Cross and Blue Shield of Illinois fraud hotline: 800-543-0867. Find out more about fraud prevention and reporting on our website.