Anyone with health insurance is a potential victim of medical insurance fraud.  The crime can range from someone using your birth date and your social security number to running up bills and creating false records in your name.  The bills can be huge for services the victim never received as well as legal, medical and insurance fraud issues that take years to untangle. 

How can you protect yourself from becoming a victim of medical identity theft?

• Protect your health insurance card.  Treat it like your ATM, debit or credit card that has a million dollar spending limit (which is the cap on how much many health insurance plans will pay for your care over your lifetime.)
• Shred old insurance statements and old insurance cards.
• Get a copy of your medical records every year from each of your doctors and review what’s there to make sure there are no errors (you may be charged for copies and postage).
• Be sure to open and read all mail from your health insurance company – especially those EOBs (explanation of benefits) statements that come after your insurer has received a claim.  Anything that’s not a service you received or remember, call your insurance provider immediately.
• At the end of each year, ask for a list of all benefits paid out in your name and challenge any discrepancies.

If you believe you’re a victim of medical identity theft – here’s what you need to do immediately:

1. Contact your health provider and insurer.  They’ll request a new card for you and have a watch put on your old one.
2. Keep careful notes which include the name and contact information of everyone you speak to (I suggest a spiral notebook rather than random pieces of paper so every conversation you have regarding this matter is contained in one place) and write the date, time and name of the person contacted and what was discussed.
3. Check your credit report with the three credit reporting bureaus (Experian, TransUnion and Equifax) because medical identity thieves can use the information they have from your health history to access your bank accounts.)  Look for errors or activity that you know isn’t yours and work to correct these errors.
4. Contact your local police and file an incident report (request a copy for your files, too).
5. File a complaint with the Federal Trade Commission by completing a fraud affidavit form which you’ll need in order to correct your records and help the government keep track of the number of medical identity

A final but important and sobering thought:  the person who steals your medical identity might have a serious condition that you don’t.  But if your records are compromised and the thief’s history is co-mingled with yours, serious challenges and concerns can arise for you should there be an emergency and you’re unable to provide answers to important questions.  Doctors and emergency rooms accessing “your” records could find information that impacts the care you’re provided.    It’s your money so take it personally (TM)  but it’s your life and well-being, so be sure the information in your medical file is all about you.

Here’s to your health and wealth.

The high cost of health insurance gets even higher when identity thieves get their hands on your medical records.   

According to the 2010 Identity Fraud Survey Report by northern California based Javelin Strategy & Research – ID theft continued to rise last year and had more victims than in any period since the survey began in 2003. 

The good news in the midst of a bad situation is that the average out-of-pocket dollar amounts victims pay reached an all time low due to better understanding among consumers about ID theft prevention, detection and resolution. 

But when it comes to your medical records, identity thieves call them “the mother lode” for committing their crimes.  After all, medical records contain everything that’s needed to establish someone else’s identity:  Social Security numbers, addresses, often even payment account information.  In fact, the most recent National Study on Medical Identity Theft by the Ponemon Institute estimates that nearly a million and a half Americans were victimized by this kind of theft within the past two years. 

Medical identity theft typically involves stolen insurance card information or costs related to medical care and equipment given to someone using the ID theft victim’s name.  More than 1-point-4 million adults have experienced some type of fraud involving theft of their medical identification information.  The dollar cost on average per victim to resolve a case of medical identity theft is nearly $21,000.  

Unlike credit card fraud where the bank eats the losses, with medical ID theft, victims often have to pay for care they never received, and some lose their health insurance because of it or are forced to pay higher premiums to restore it.  Victims are often forced to sort out the fraud from fact with doctors, hospitals, insurance companies and credit agencies. 

It’s your money so take it personally ™.  Next week, how to protect yourself against medical identity theft. 

Here’s to your health and wealth.

TAGS: Medical identity theft

When times are hard, opportunists look for soft landings which is just another way of saying they look for easy targets.  I don’t want you to be one of them.

It’s truly a perfect and decidedly unhealthy storm in our country’s health care arena:  the recession, high unemployment and the prolonged debate among lawmakers regarding health care reform.

The best offense is a good defense.  So always be a doubter when approached (often by fax or email) by someone offering health insurance policies chocked full of benefits at cheap rates.  And please – do not cancel your existing, valid health insurance policy until you absolutely, positively know what the new health insurance policy you’re considering really gives you.

The horror stories are real.  And they’re painful.  Fake policies not worth the paper on which they’re written; deceptive policies that have hidden, expensive costs.  They’re scams – and there are a lot of them out there.

So how do you know the real “health” of a health insurance policy?

• Know who’s for real.  Contact your state’s insurance commissioner to see if the policy you’re considering is with a reputable company.  The company should have a license on file.  Check with the National Association of Insurance Commissioners (http://www.naic.org) to see if any complaints have been filed against the company, the agent or both.
• Don’t be rushed.  Take time to have a good look at the details in the proposed policy.  Fact check promises with what the company has delivered to existing policyholders.  How do you do that?  Ask for references.  Google the agent and company.  It’s amazing the random and often pertinent facts (or at least inquiries) that you can find.
• Demand full disclosure.  It’s never a good idea to do business with a company that won’t provide full contact and location information or only offers an 800 number for phone contact.
• Be wary of “too good to be true” deals.  They usually are – too good - and not true.  Compare the policy you’re considering with comparable policies.  If the price points are dramatically different – there’s a reason – and that usually means a red flag.
• TMI request.  It’s never healthy to give too much (personal) information during a sales presentation.  Your Social Security number, bank accounts, retirement accounts, portfolio details are not required in order for a legitimate insurance agent to give you a policy proposal so don’t be intimidated into doing so.  If pressed, go elsewhere.  There are many good and legitimate agents and companies in the business.
• Too easy to get is too good to trust.  The reality of a pre-existing medical condition is one that’s facing many Americans.  If someone’s offering you a policy regardless a pre-existing condition, which requires no medical examination and is so much easier to get than any other you’ve tried – stop!  If the price offered is too low for the level of benefits promised, it is likely a scam.

Remember that mind over money – matters.  Take a good look at the health of the insurance policy you’re considering.  Make an informed, conscious decision about your medical insurance options before a medical crisis challenges and plays on your emotional state of well being.

Here’s to your health and wealth.

TAGS: Health insurance, scams, tips on how to find good policies