The X-ray brings bad news: broken hand. The bones will have to be held in place by a titanium plate. Then a cast. Then a brace and months of physical therapy. It’s 2006 and MMA is starting to boom. However, he can kiss those contract offers goodbye for now.
“Mr. Swanson, how would you like to pay for this?”
The bill: $5000, due in full, two hours before surgery two days later. Featherweight Cub Swanson has never had health insurance. He is a professional fighter and is used to scrambling. He calls a few friends and borrows cash with a promise to pay them back. Maybe next fight, whenever that is.
The definition of hurt changes when you fight for a living. Is it bad enough to keep you from work? You don’t get paid when you don’t fight. Turning down work looks bad, and there are dozens of others just like you who will say yes. If an injury is bad and you’re uninsured, you can go to a doctor and pay through the nose or ignore the bills and ruin your credit. Or, you can make it to the show and fight, and the promoter—in theory—will fix it.
The industry-leading UFC provides a $100,000 insurance policy per fighter at an event. If you get hurt in a fight, your bills are paid in full. Many fighters, as a result, have walked into the cage far from 100 percent. They’ve routinely fibbed on pre-fight medical examinations for post-fight treatment. Some have fudged the date of injury on insurance paperwork.
UFC parent company Zuffa has routinely gone beyond its legal responsibility and paid out-of-pocket for medical needs of those without health insurance, though its official position was that fighters had to pay for out-of-competition care. Six months ago, however, the company took a bold step. Zuffa purchased a policy that offers accident-insurance coverage of up to $50,000 yearly to the 350 fighters under contract, including the UFC and Strikeforce. If you bust your ACL in practice, or have to get an MRI, or slip down a flight of stairs, anywhere in the world, you are covered. Fighters won’t get paid for a missed fight, but at least the medical bills won’t put them in the poor house. In the past, that was a distinct possibility every time they walked into the gym.
A vast network of gym doctors still patch cuts and immobilize shoulders for the thousands of up-and-coming fighters who don’t have the Zuffa safety net, and fight-night insurance still does a lot of heavy lifting for medical treatment in MMA. If you fight outside of the UFC, the choice is pretty tempting, even if you may have to chase your money later. In Swanson’s case in 2006, the promoter’s insurance didn’t pay the whole bill, and it took him five months to collect. At the time, though, it was the only choice he had.
June 2, 2011. It’s sparring day at Jackson-Winkeljohn Martial Arts, and Swanson is going against a tough—or maybe just reckless—customer who throws a flying knee like he’s in a fight. The guy (Swanson won’t name names) doesn’t know the pad protecting his patella has slipped down. The knee slams straight into the left side of Swanson’s face. In caves his cheekbone. It breaks his orbital and nose, cracks his jaw, and pushes back all his teeth. There is sharp pain, then everything goes numb.
“I just walked off the mat, and people started asking me if I was alright,” Swanson says. “ I said, ‘No.’ But I had no idea that I’d broken that much stuff in my face.”
He needed no convincing to go to the hospital. UFC vet Joe Stevenson took him to the facility at University of New Mexico, where a CT scan confirmed the gruesome extent of his injuries. Thankfully, his left eye was fine. But he absolutely, most certainly, without a doubt needed surgery. (Later, two surgeons wired his jaw shut and put three metal plates in his face.) He’s supposed to fight Erik Koch in four weeks. Stevenson calls the UFC: “Has that new accident-insurance thingy kicked in yet?”
“Yeah, it did yesterday,” answers the employee. “Why do you ask? What happened?”
There have been 43 documented injury withdrawals since the policy took effect, only three more than the previous six-month period. Still, with the loss of several high-profile fights on the UFC’s calendar in recent months, some have speculated that the program is doing its job too well. “That’s not true,” says UFC president Dana White. “Before we started the insurance, guys were getting hurt. We’ve been on a streak now for, God, it feels like it’s been two years.” The economics of pulling out of a fight still don’t make sense, he argues, even with the insurance policy in place. You get paid far more for fighting than not.
Still, some fighters aren’t using the new program. While Zuffa pays the policy’s premium, there is a $1500 deductible for which fighters are responsible in the event of an accident that requires medical treatment. Some fighters already have standard health insurance through spouses or jobs. Featherweight Mackens Semerizer suffered an injury that forced him to withdraw from UFC 134, and he used the insurance he receives through his work as a military trainer because the deductible is lower. Additionally, the program excludes pre-existing conditions. If, say, a fighter re-injures a shoulder he blew out 18 months prior to the policy’s start date, he’s not eligible for reimbursement. The program also doesn’t provide coverage for the sickness that inevitably attacks a fighter late in camp as his immune system is pushed to its limit.
Nevertheless, those interviewed by FIGHT! praised the program’s ease of use. When billing issues arise, fighters direct the doctor or hospital to a full-time Zuffa employee assigned to handling accident-insurance claims—most never see a bill. One fighter who paid several thousands out of pocket for several doctor visits complained of a delay in reimbursement—likely due to limited manpower at Zuffa’s main office—but most said the process was turnkey.
“It was a good feeling to get covered,” says Phil Davis, who was forced to withdraw from a headliner opposite Rashad Evans at UFC 133. “That’s how I hoped it would be one day. That’s what I’m used to from college athletics. I’m glad it’s there.”
At 27 years old, Swanson has endured popped ribs, hyperextended elbows, a torn AC joint, and all those broken hands. Two weeks before his second professional fight, he split his knee open at a park. Instead of getting stitches and giving up gym time, he had his brother cauterize the wound with a red-hot knife, Rambo style (it took two tries). Swanson is perhaps two years from his athletic prime. There is no other option but to fight on, as long as doctors tell him he can fight. “I haven’t fulfilled my expectations,” he says. “I knew this was a tough sport when I started, and I’m getting tested.”
At the time of his interview, Swanson was three weeks out from his Octagon debut at UFC on FOX 1, four months after it was delayed by that crushing knee. Mr. Reckless paid the $1500 deductible— only fair, right? He later learned the total bill was just under $50,000. Swanson takes extra precautions in the gym and tries not to think about what’s next to break. That’s no way to train, much less fight. After they wired his jaw shut, he had a quote from Sun Tzu’s Art of War tattooed on his skin: “Victory is reserved for those willing to pay its price.”
The safety risks of MMA likely won’t change. However, thanks to UFC’s new insurance policy, the price has. 
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