The $31 Billion Health Insurance Mistake (and How to Avoid It)

Written By
Paul Tracy
Updated January 16, 2021

You see your health insurance as a safety net that's there in case you need to go to the ER or fill a prescription, have strep throat or develop a life-threatening condition. You rely on it to keep you healthy and protect your wallet in the event of a health crisis. But experts say not safeguarding your healthcare insurance information is one of the worst mistakes you can make.

That mistake can cost you dearly because identity thieves who rely on your medical and health insurance information for their livelihood see your life insurance as a way to make big bucks.

According to a 2011 study by the Ponemon Institute, a whopping 1.42 million Americans fell victim to medical identity thieves; the annual economic impact of that medical identity theft was $30.9 billion, or more than $217 per victim.

It's no wonder that healthcare-related fraud is on the rise. According to the World Privacy Forum, a stolen Social Security number has a sells on the black market for around $1; stolen medical and healthcare information sells for a staggering $50. 

"One of the biggest health insurance mistakes that costs consumers and insurance companies millions is failing to safeguard health insurance information as they would their financial information," says Michael Nusbaum, MD, and founder of MedXCom, a software company for physicians. 

"Health information is stolen for prescriptions, surgery and treatments leading to misdiagnosis and credit issues for victims," says Nusbaum.

Robert Siciliano, a personal security expert and security consultant with ADTPulse says underestimating medical identity theft is common. "Many think identity theft is only a financial crime but you need to be aware that medical identity theft, when someone poses as you to get medical attention, also exists," he says. "Thieves will also use a person's social security number to obtain health insurance."

Spotting the Signs That You've Been a Victim

How can you spot that your health information, or health insurance information, has been compromised? According to the Federal Trade Commission (FTC), you may be a victim of medical identity theft if:

  • You receive a bill for medical services you didn't receive.
  • A debt collector contacts you about medical debt you don't owe.
  • There are medical collection notices you don't recognize on your credit report.
  • You try to file an insurance claim and it' denied because you're health plan says you've reached your limit on benefits.
  • You are denied insurance because your medical records show you having a condition you don't have. 

Protecting Your Health Insurance-Related Information

Lock It Up: Don't keep copies of your medical or health insurance records in your office/purse or other vulnerable spot – anyone can copy this and use the information. Instead, treat anything with patient identifying information as if it were a bank statement or credit card, after all, it could have your social security number on it. Store valuable health information in a safe place in your home like a locked desk drawer or file cabinet– out of the wandering eyes of guests to your home. 

Zip Your Lip: Many people are vigilant with their financial information but Nusbaum says they'll freely speak in public (in line at the grocery store, while getting a haircut or at a child's soccer practice) about prescriptions and medical information that can easily be stolen and used. Only discuss your healthcare information and medical history when you're sure you can have a private conversation (in your home, in an office with a door, in your car with the windows up, etc.).

Secure Your Safety: If you email your doctor regarding medical treatment or entering your information in an online HIPAA compliant patient portal, only use a secure site. To spot a secure site, look for a lock icon on the browser's status bar or a URL that begins with "https". The "s" means the site is for secure and there is a much lower risk of any information being stolen from the site. 

Support, Don't Overshare: Never share personal data (Social Security number, prescription numbers, health insurance plan details, etc.) on online support sites. Nusbaum says thieves often pose as patients trying to gain access to patient's information on support sites and forums. 

Steer Clear of the Trash Can: "Always shred your health insurance forms, prescription and health documents once you're sure you don't need them any longer," says Nusbaum.  

The Investing Answer: Siciliano says you should never ignore the signs your healthcare information may have been compromised. Doing so can cost you hundreds or thousands in health insurance claim denials.

If you suspect you've been a victim of healthcare fraud or medical identity theft, contact the police immediately. And make sure you and copies of the report to your health insurance plan's fraud department, your health care provider(s), and the three nationwide credit reporting companies. Tips on how to file a healthcare ID theft-related police report are available on the FTC's website

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