Medical identity theft occurs when someone uses your personal information to access medical services, equipment, or medications for themselves. This can sometimes lead to complications—for instance, changes to your medical records might result in treatments that aren’t suited for you. To prevent this type of identity theft from happening to you, keep on top of your healthcare and credit reports and communicate with your providers through their secure online portals.
Medical identity theft delivers a one-two punch to its victims. First come all the headaches of “regular” identity theft—potentially destroying your credit standing, for one—and then come the real-life dangers that can occur when someone tampers with your medical record.
Before we walk you through what can happen and what to do about it, let’s start at the beginning.
What is medical identity theft?
Medical identity theft occurs when someone uses your personal information, like your name, birth date, Social Security number, and/or your health insurance policy numbers to obtain healthcare, score prescription drugs, or get fraudulent healthcare reimbursements.
Medical identity thieves can exhaust your benefits for their gain, alter your medical records, or affect your medical treatments because your records have merged unbeknownst to you, your doctors, and your pharmacists.
NPR notes that three main categories of people commit this specialized form of identity theft: handbag and wallet thieves, data breach thieves and their customers, and family members who have access to your health information.
Does medical debt affect your credit standing?
In January 2025, the Consumer Financial Protection Bureau determined that medical debt cannot affect how lenders judge those who apply for credit. This marks a silver lining for victims of medical identity theft.
That said, CNBC reports that if the identity thief opened a credit card or obtained a loan using your information to cover their medical costs, your credit would be affected, reports. In that case, you would have to follow the requisite steps to restore your credit and untangle your medical identity issues.
How to know if you’ve been affected by medical identity theft
As with other forms of identity theft, there are telltale signs for victims. For example, you might:
Receive an explanation of benefits (EOB) for treatment you never received
Get denied insurance coverage for a condition you don’t have
Run out of refills when you know you’ve taken your meds on schedule and according to your doctor’s orders
Receive medical bills for services or equipment that you never received or needed
Get contacted by debt collectors
Get calls, emails, regular mail, and texts for specific medical equipment you don’t need
What’s an EOB?
An explanation of benefits (EOB) is medical industry speak for a list of care (and equipment) issued during a specific visit to a healthcare provider. It can include what facility was visited, the practice, the care, prescribed equipment, and sometimes what insurance paid versus what you may owe.
If you get an EOB for a service or equipment you never received, it’s one of the surest signs you’re a victim of medical identity theft.
How to protect your medical identity
Identity thieves tend to target "low-hanging fruit”—like individuals with weaker security measures in place.
Don’t make it easy for them. Here’s how to stay ahead and protect your medical information:
Don’t click on emails or texts or open attachments from your providers. Instead, use the correspondence to spur you to log in online to check any messages. Stick to corresponding via your secure patient or member portals.
Remove labels from pill bottles and medicines before recycling or trashing. Can’t peel off those labels? Color over them in permanent black ink.
Shred your insurance and medical bills and any EOB you may receive.
When possible, don’t share your complete Social Security card number with providers. See if you can share the last four digits, if possible.
Always set up multi-factor identification when offered.
Keep track of your insurance cards. Don’t leave them where others can access them.
What to do if you become a victim of medical identity theft
First, reach out to the provider who issued the EOB that set off your suspicions of medical identity theft. If they stand by the EOB, then it’s time to get to work rectifying your records, accounts, and name.
If you're an Allstate Identity Protection member, we’ve got your back—just give us a call, and we’ll work on resolving the issue for you. If not, here’s a good place to start:
File identity theft reports. File these with the Federal Trade Commission (FTC), your local police, and your health insurance’s fraud department. The FTC’s site will walk you through how to resolve the problems.
Share the theft report with providers. The Office of the Attorney General of Virginia lists these potential providers: doctors and nurse practitioners, hospitals, medical transport operators, nursing homes, home health providers, rehabilitation providers, and labs.
Get a copy of your medical records, including the treatment the thief received using your information. If your healthcare provider protests, contact the person in their office who handles all things related to the Health Insurance Portability and Accountability Act (HIPPA). The FTC reports, “The HIPAA Privacy Rule gives people the right to copies of their records maintained by covered health plans and medical providers.” The agency continues, stating, “Patients may ask for copies of their medical and billing records to help identify the impact of the theft, and to review their records for inaccuracies before seeking additional medical care.”
Review and rectify your medical records. Purge any treatment provided or conditions reported by the thief. Do this with any provider that has access to your records. (This might mean contacting multiple healthcare systems and insurance companies.)
Obtain your credit reports. Report the medical identity theft to the three nationwide credit bureaus, Equifax, Experian, and TransUnion. Contest anything (like accrued credit card debt) related to the medical identity theft.
Freeze your credit. If the thief stole your identity for medical fraud, they could also use your information for financial gains. Freezing your credit takes away one avenue for that.
Your health information should be yours alone. With a little awareness and the right protection in place, you can stay in control and guard what matters most.
