Medical Identity Theft


Medical identity (ID) theft occurs when someone steals personal information – such as a beneficiary’s name and Medicare number – and uses the information to get medical treatment, medical equipment, prescription drugs, surgery, or other services and then bills insurance (such as Medicare) for it. When Medicare beneficiaries fall prey to consumer scams aimed at obtaining Medicare and/or health ID numbers, their Medicare and/or health ID number is considered to be “compromised” as a result of medical identity theft.

Medical identity theft can also affect beneficiaries’ medical and health insurance records. Every time a scammer uses a beneficiary’s identity to receive or bill for care/supplies, a record is created with incorrect medical information about them.

Report potential medical identity theft from fraud, errors, or abuse if:

  • You gave out your Medicare and/or health ID number:
    • Over the phone or internet to someone offering durable medical equipment, genetic testing, COVID-19 testing/supplies, back braces, etc.
    • At a fair or other gathering as a check-in or to receive free services
    • In response to a television or radio commercial, Facebook ad, postcard, or print ad requesting a Medicare number
  • You see on your Medicare Summary Notice (MSN) or Explanation of Benefits (EOB) charges for medical services or equipment that you did not receive
  • You are contacted by a debt collection company for a provider bill you do not owe
  • You received boxes of braces, testing kits, or other medical supplies in the mail that you did not request
  • A Medicare and/or a Medicare Advantage plan denies or limits your coverage or benefits because of a medical condition you do not have
To learn more about tips related to medical identity theft, click here.

To learn how to read your Medicare Summary Notice (MSN) and Explanation of Benefits (EOB), click here.

Report Suspected Fraud

To report suspected fraud, click here.

SMP Resources

Other Resources