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Scammers never rest. Even when the government and financial institutions take added measures for protecting consumers against fraud, scammers are dreaming up new ways to con you out of your money – and your identity. In the latest wave of identity theft, scammers are cashing in on Medicare’s extra level of protection. In order to help prevent ID theft, Medicare is replacing the Social Security numbers that had appeared on its old cards with an 11-digit code. The new cards aren’t in circulation yet. They will be mailed out within the next 13 months, but scammers are already using them for a new variation of identity theft – medical identity theft.

Here’s how the medical identity theft scam works:

A caller pretending to be a Medicare representative will phone a beneficiary and ask for payment in exchange for the new ID. The victim willingly complies. In reality, though, the new cards are free and are being mailed out automatically. The caller might also claim to be a Medicare representative who is not after the victim’s money but needs their medical information to send out their new card or to update their system.

In another iteration of this scam, a caller will ask a victim if they want to purchase Medicare’s prescription drug coverage, or Part D. Part D is voluntary and is not necessary for Medicare coverage, but the caller will insist the victim must purchase Part D or risk losing their entire coverage.

In another ruse that is not limited to Medicare members, the caller will ask for the victim’s checking account number and Social Security number to deposit a supposed refund from their medical insurance company.

Once the scammer has the victim’s medical information, though, there’s an endless amount of damage they can do, including (but not limited to):

  • Posing as the victim to see a doctor and using their insurance to pay the bill,
  • Obtaining prescriptions they don’t need and then selling them or misusing them,
  • Purchasing medical equipment,
  • Filing a false health claim.

Protect yourself from being the next victim! Here’s what you need to know about medical identity theft.

What it can cost you

According to the Ponemon Institute, the average medical identity theft costs the victim a whopping $13,500 to fix. But it’s a lot more than money at stake. There are several significant ways medical identity theft can affect you.

1.) Loss of health coverage

Medical identity theft can cause you to lose your health coverage. Scammers might max out your benefit limits and leave you at a real disadvantage in case of a medical emergency.

2.) Ruined credit history

Medical identity theft can wreak havoc on your credit history. You may have spent years building and maintaining an excellent score, but scammers can bring all of that tumbling down by racking up tremendous hospital bills in your name and then disappearing. The outstanding bill will then go to collections and you might not even be aware of it until creditors come calling.

3.) False medical records

The scammer may be seeing doctors, receiving treatment, and obtaining prescriptions under your name. All of this will be documented on your medical records. This can prove to be extremely dangerous, or even fatal when you seek medical attention in the future.

4.) Higher premiums

When insurance companies take note of the maladies you’ve “contracted” or the many doctors you’ve been “seeing,” your premiums will likely rise.

Preventing medical identity theft

Learn to recognize the signs and take proactive steps to ensure that you’re not the next victim of medical identity theft.

  • Know that Medicare will never call you for information. The agency will always reach out to its members via mail. By simply being aware of this fact, you can immediately identify a scammer on the phone.
  • Be wary of bills from third-party providers. If you receive notices regarding your medical information from a third-party provider that do not look familiar, or that contain inaccurate information regarding your medical history and recent treatment, alert your insurance provider immediately.
  • Study your Explanation of Benefits (EOB). Every health insurance company provides its members will an EOB. Be sure to take a hard look at yours. If you spot any treatments you don’t remember receiving, notify your insurance provider immediately.
  • Check medical records. It’s a good idea to review your medical records on a regular basis and check for any suspicious doctor visits, prescriptions, or maladies.
  • Review your credit. It’s always prudent to check your credit history several times a year. If you see any unfamiliar charges, immediately ask for a fraud alert and place a freeze on your credit.

Fixing your medical history

If you spot something suspicious on your medical records, it’s crucial that you take the necessary steps to correct it so it doesn’t affect your medical treatment in the future.

Send a copy of the documents detailing the discrepancy or error to every medical professional and facility involved in your care, including doctors, hospitals, labs, and private clinics. It’s best to send a copy of these documents and keep the original documents for your own records. To ensure that the correct parties receive the documents, send them through certified mail and get a receipt.

Fighting back

Have you been victimized by medical identity theft? Report the incident to prevent future scams!

You can report your scam on the Federal Trade Commission (FTC) website at, or by calling the agency at 1-877-438-4338.

If you are a member of Medicare and suspect fraud, call 1-800-MEDICARE for assistance or visit Alternately, report the scam to your own insurance provider.

You deserve to live out your years in health and happiness without worrying about medical identity theft. Make sure you take the necessary precautions to ensure you’re not the next victim!

Your Turn: Have you had to repair damages caused by medical identity theft? Share your experience with us in the comments!

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