Think your health insurance covers that? You might want to check again.
The Australian Competition and Consumer Commission has found insurers are not adequately notifying customers when their coverage or benefits are slashed, and - in some cases - failing to disclose changes entirely.
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The more extreme failures identified by the consumer watchdog's annual report on health insurers related to contract changes between insurers and health providers, which would affect benefits payable to customers.
Confusing and "unhelpful" communication tactics included unclear and misleading language, single notifications without follow up, relying on email, and the blending of benefit change information with marketing information, the ACCC reported.
These poor practices are leading to bill shock, inadequate cover and reduced access to health care, warned ACCC Deputy Chair Delia Rickard.
"If consumers are not given clear notice of changes to their insurance, unexpected out of pocket expenses and limits on their access to medical treatment can cause great harm and detriment," she said.
The Private Health Insurance Ombudsman received 736 complaints related to information provided by insurers in 2014-15, a 62 per cent rise over two years. In 2015-16 the ombudsman received 599 complaints about information provision.
Many complaints to the ombudsman about a change in insurer rules in 2015-16 related to exclusion of IVF, gastric banding, spinal surgery and significant hospital downgrades, the ACCC reported.
Some of these complaints would have related to changes made years beforehand. For example IVF and gastric banding changes were also the subject of complaints in 2014-15.
Insurers are required under Australian consumer law to give clear, advance warning when they cut cover or benefits.
The ACCC launched Federal Court proceedings against Medibank Private in June, alleging Australia's largest health insurer had engaged in misleading and unconscionable conduct by not telling policy holders itno longer covered common hospital tests, including X-rays and blood tests.
"The ACCC will continue to work with insurers to improve compliance with the ACL (consumer law), particularly around how insurers communicate benefit changes to their customers," Ms Rickard said. "We will also take enforcement action where it is needed."
Rising complaints against Medibank contributed significantly to a record 4416 complaints to the ombudsman in 2015-16.
The ACCC found the growing number of policies on offer, as well as changes to benefits and the rise of policies with restrictions and exclusions was contributing to confusion for consumers.
Consumer Health Forum chief executive Leanne Wells said the Private Health Ministerial Advisory Committee - which includes academics, industry, medical and consumer groups - was looking at the provision of information to health fund members.
"It is a concern that the dynamics of health insurance are tending to worsen the causes of bill shock and failure of health funds effectively to alert their members of changes to coverage that can leave patients with high out-of-pocket expenses they were not expecting," she said.
Rachel David, the chief executive of Private Healthcare Australia, said work was under way to improve communication with policy holders.
"The industry has committed to addressing this by working on common clinical terminology to define products with exclusions, improved transparency to consumers and better mechanisms to help consumers navigate the private health system," Dr David said.
"The industry is aware the private health system and its rules can be confusing, which is why we are working with the federal government on improving transparency in the sector."