Could you fall victim to medical identity theft?

Palm Coast woman faced more than $250K in bills for someone else's surgeries

JACKSONVILLE – Imagine being rushed to a hospital with a serious injury, only to learn someone else already had a major surgery on your dime, and the thief used your insurance information in another state.

That's precisely what happened to a Flagler County woman who shared with News4Jax about how she became the victim of medical identity theft.

More than half a million Americans had their medical identities stolen last year by people desperate for medical treatment who don’t have health insurance themselves, according to a Wall Street Journal study.

Some thieves steal medical identities for cancer surgeries or open-heart procedures. In the case of one Palm Coast woman, a stranger with diabetes had a leg amputated using the woman's medical information, which the woman said was stolen from a hospital. 

“Obviously, I have two functioning legs. So how could I have had a leg amputated?" said the woman News4Jax is only identifying as Lisa. "And she said, 'You had your leg amputated,' and I said, 'No, I don't think so, I’m a soccer referee. I ride horses. I compete with dogs, no, I have two legs,' and she’s like, 'Well, according to our records, you had surgery.''” 

Lisa said she still has a hard time convincing her insurance company that someone stole her medical identity.

“The person had their leg amputated because of diabetes," Lisa said. "I am not a diabetic."

Lisa said her insurance company tried to charge her more than a quarter of a million dollars in bills associated with the leg amputation six weeks after she had surgery on her shoulder. She later learned her medical identity had been used in California, Michigan, Georgia and Palm Coast.

“There were the big hospital bills, and all the associated physical therapy, prosthesis, medications, nursing, at one point there was nursing, and there was a home where this nurse was going to, but of course, nobody was able to trace it back. You don’t get a lot of cooperation with trying to solve this problem,” said Lisa.

Lisa said she suspects her medical information was stolen by an employee of the hospital where she had her surgery, and then sold on the underground market to someone desperate for health care.

Since 2011, the number of Americans whose medical identities have been stolen has increased more than 20 percent annually. Most victims end up paying approximately $2,500 to have the situation resolved.

"Identity theft medical isn’t just your health records that they are stealing. It's not just your coverage they are stealing," Lisa said. "They are stealing your whole life, and they are stealing your well-being. It’s hell, and I think the thing that scares me the worst is if anything happens to me, it wouldn’t be my medical information."

Experts said, for example, that if a person is involved in a car accident and needs an emergency blood transfusion, the indicated blood type might not be theirs if they have been a victim of medical identity theft. That mismatch could cause shock or even death.

“It’s life and death for some people,” according to Neil Villacortabuer, a privacy and security officer for Family Care Partners.

Villacortabuer said that far too often, smaller medical care providers don’t have the adequate training or technology to combat the cybercriminals who are selling a person’s full medical identity for a thousand dollars.

“The medical industry really lags behind the financial industry and a lot of other sectors in protecting that information. When you think of all the little mom-and-pop medical practices, most of them can’t afford a real security team or security official, so they’ll have computers there that are unsecure, not password protected, and also a lot of the data is not encrypted,” Villacortabuer said.

To protect your medical identity, security experts warn against the following:

  • Tweeting or posting Facebook updates about your medical issue or a family member's medical issue. That information could make you more of a target, especially if you have good health insurance.
  • When you fill out paperwork in a doctor’s office, ask to only to fill out the last 4 digits of your Social Security number, because the rest of the information doctors need should be on your medical insurance card.
  • Check your explanations of benefits or Medicare summary on a quarterly basis.
  • Freeze your child’s credit until he or she turns 16 years old.

READ MORE: Federal Trade Commission on Medical ID Theft

“People are desperate. I don’t know about you, but my insurance premiums are more than my mortgage here in Jacksonville, and so I know it costs a lot of money, and with people not at that level, it just all adds up and people take their health for granted,” said Villacortabuer.

“I still have negative things on my credit reports," Lisa said, "that have cost me money on my mortgage, cost me money on my car loans, cost me money on my insurance insurance, because it shows up as not a good credit score because of all these bills."

Lisa said her insurance company now has to have all of her medical claim paperwork notarized before she can get them to cover her doctor visits or procedures. The person who originally stole her identity has not been caught.