UFC fighter outlines issues with health coverage

January 6, 2014

Bloody Elbow reports on the issues UFC Lightweight Conor Heun has had in paying his medical bills despite being covered by UFC medical insurance.  He has declared bankruptcy due to unpaid medical bills.

Heun has multiple issues with his body which has precipitated multiple surgeries.  The issue with Heun’s medical coverage was that his doctors did a procedure on the hip of his right labrum that was deemed not medically necessary.  Heun stated that the plan covered about $200k of his surgeries but billed him for the procedure as the claim was denied.  Heun stated, via twitter, that the UFC was going to cover the surgery (presumably the portion not covered by insurance) but not cover his rehabilitation from the injury.  He claims that he still has 39K in unpaid medical bills.  The tweet has now been deleted.

Payout Perspective:

The first question that you might ask is who to blame?  In this instance, the UFC may be the least responsible.  Sure, it was the one that provided Heun with the medical insurance for which a portion of his medical bills were not covered.  But, the organization likely signed on with a standard medical insurance policy and did not know what was and what was not covered.  It’s a tricky subject and the costs likely exorbitant for the UFC to cover every type of procedure to make its fighters better.  Moreover, it’s unlikely an insurance company would offer this type of coverage, especially to an MMA organization when it knows it will be paying out for many of its policyholders.

Like anyone else with medical insurance, there are things that insurance will pay, and others that it will deny for one reason or another.  Here, according to Heun, his doctors did the procedure without knowing it would not be covered.  But, from my experience, the doctors usually do not know what is covered by insurance.  Rather, they do what they believe is medically necessary and do not check with the insurance company.  While support staff for the doctor could have checked with Heun’s insurance, it likely did not happen here.

Is it the insurance company’s fault?  Of course it is.  I am half-joking here, but what’s not being asked is whether Heun appealed the decision.  There are times where if the policyholder persists and appeals the denial decision, it may be reversed.  Certainly, there are times that you have to be persistent with insurance companies.

Is it Heun’s management’s fault?  It could be if Heun had a manager that should be on top of these types of things.  While we write a lot about sponsorships for fighters, it seems like a part of a manager’s job is taking care of their medical issues.  Strapped with hefty medical bills, there should have been some talk with either the hospital or insurance company as to how to deal with the situation.  Was Bankruptcy the answer?  Perhaps.  But filing for Chapter 7 (or 11) may create a whole other set of problems.

In the end, it was not Heun’s difficulty with UFC insurance, but the broader problem with the medical insurance industry.  Patients are not clear what is or are not covered and are not given sufficient information on how to address the situation.

34 Responses to “UFC fighter outlines issues with health coverage”

  1. Diego on January 6th, 2014 10:55 AM

    US healthcare insurance is a black box with a roulette wheel inside. No one can predict whats going to come out.

    My wife had an issue where she called a doctor’s office to make sure they accepted her insurance, but when the doctor sent the bill to the insurance company, the insurance company decided that they wouldn’t cover it. The doctor’s office then sent my wife the bill. It took a while to sort out but in the end we didn’t pay. Each case is different but I think in our case the doctor saw that my wife has good insurance and added a bunch of tests that the insurance company did not feel where necessary, or simply overpriced the tests to the point where the insurance company refused to pay.

    If Heun was told by his doctors that he needed the surgery, that would make it medically necessary IMO. Unfortunately for him, my opinion is worth jack & sh*t and it’s the insurance company’s opinion that matters. I feel like there is some room for negotiation here between Heun, the hospital and the insurance company, but if the UFC is stepping in I’m sure they are getting their lawyers involved.

  2. Diego on January 6th, 2014 10:58 AM

    The scary thing is that you can think that you’ve done everything right – you check to make sure the medical facility takes your insurance, you follow your doctor’s suggestions regarding the medical procedure, etc – and after the fact the insurance company can decide not to pay and you get stuck with the bill.

  3. Chris27 on January 6th, 2014 11:39 AM

    Tweet deleted, I guess he got taken to the woodshed by DW.

    He should sign up for Obamacare.

  4. Machiel Van on January 6th, 2014 12:20 PM

    Chris27,

    He was told that the UFC would pay for the uncovered surgery, but not for the rehab.

  5. ChrisC27 on January 6th, 2014 1:11 PM

    Who is this fake Chris27 and why is he posting under my name?

  6. Jason Cruz on January 6th, 2014 1:30 PM

    @MV and Chris

    So I think the question is whether the UFC stepped up and paid for the unpaid med bills and that’s the reason for the deleted tweet. Or, as Chris indicated, he’s not going to be nominated for Tweeter of the Month in the UFC. (i.e., he’s in trouble).

    Its clear that the UFC was not going to pay for the rehab costs but are those costs tied in with the med bills…

  7. dfdfdfdf on January 6th, 2014 3:19 PM

    Dana White announced Domick Cruz is injured and stripped of his title on ESPN…
    Dana White has been kissing ALOT of ESPN a55 lately… makes you wonder WHY?

    1.) UFC is getting dumped from their FOX contract for not performing…
    2.) FS1 is getting canned as a total failure…
    3.) UFC is trying to get out of their Fox contract and onto another platform…

  8. BrainSmasher on January 6th, 2014 6:07 PM

    The real issue here is what is becoming typical of people these days. The first thing that doesn’t go his way. He runs to slander everyone and anyone. Pointing the finger at everyone but himself. When you have a procedure that isn’t required you have to shoulder some responsibility. If you do not know what your insurance covers and doesn’t. You have to shoulder some of that responsibility. When you come out and go after a company who provided you with free insurance that just picked up the bill for 200,000 and the insurance company itself. You come off as a ungrateful douchebag!

    This was not the way to handle this. Trying to blame the UFC and its insurance for his bankruptcy, a outcome put in motion by his own decision, is just plain irresponsible!

    Every policy has its limits. There are tons of people in this country who are always pushing the limits or going past them. Then cry when it isn’t covered. That isn’t the coverage they have been paying for. There needs to be some accountability by the policy holder! I know what my coverage on my car insurance. I know if I plow into a Bugatti Veyron that my insurance isn’t going to come up short covering it. It isn’t no ones fault. That does happen in life. Not everything has to be someones fault. But I am still responsible for it. Conner’s situation sucks. But it isn’t no ones fault. But it if comes out that is not part of his policy and the insurance company doesn’t pay. Then that is his responsibility. You cant pass your bad misfortune onto someone else. Its your bitter pill to swallow!

  9. AK on January 6th, 2014 8:13 PM

    Urghhhh, before this inevitably turns into a “this clearly shows the superiority of universal healthcare systems. All you evil right wingers die and go to hell!” politics discussion, the avg wait time for elective surgery in Canada, just to use one example, is four-plus months.

    And Diego, in case you missed it, my response to your response http://mmapayout.com/2013/12/ufc-ppv-2013-review-updates/. And can’t really argue with your “black box with a roulette wheel inside” remark. It is almost FUBAR, and we spend more as a percentage of GDP than any country in the world. By far.

  10. Tops of on January 6th, 2014 8:30 PM

    Here we go again…what a cheapie promotion UFC is…..tsktsk…pathetic

    Good point on espn angle dfdf

  11. Random Dude on January 6th, 2014 8:51 PM

    The only people on this site who have tried to bring up politics have been BrainSmasher and AK. For some reason you guys love talking about liberals and going on political rants.

  12. Random Dude on January 6th, 2014 8:53 PM

    I forgot, you guys also like to talk about homosexuals and how they destroy everything in the world too.

  13. AK on January 6th, 2014 9:18 PM

    Oh hey Random Dude, still working on an asinine retort here??

    “How is the HBO/Goldenboy-Showtime split an example of cooperation? How in any way, shape or form is that good for the fighters OR fans???

    ANY sources to back up the mob assertions?

    Your statements on regulated markets is completely asinine and folly. You obviously have little to none real-world or business experience — by and large, owners and businessmen HATE regulations, as they often require excess time and costs devoted to abiding them. Hence the REQUIRE part. I don’t know if your wires are getting scattered between “sanctioning” and “regulations,” but it makes absolutely no sense.

    You did not answer my question at ALL as to why everyone doesn’t do it that way. For the life of me I don’t understand your talk about monopolies being bad for the company’s business. Yes, they’re generally bad for the workers and consumers, but the entire reason people STRIVE toward unofficial monopoly status is in order to, well, have a monopoly and control the entire market. It’s not worth going into the nitty gritty and nuances of why the following are or are not technically “monopolies” and thus allowed to exist in current form, but it’s seemed to work out pretty damn well for the MLB, NBA, NFL, NHL, WWE. Why wouldn’t it be good for UFC and MMA???”

  14. AK on January 6th, 2014 9:27 PM

    Oh hey Random Dude, still working on an asinine retort here?? http://mmapayout.com/2014/01/prelims-and-other-ufc-168-programming-score-big/

    And name one time homosexuality has been brought up by me. And please don’t go the “Hahaha, you are SO stupid, you can’t even tell when I’m joking” route. You DON’T joke about crap about like that (and by “you,” I am excluding you. I’m simply referring to most decent, rational human beings — not those who abuse the gay/race/class card as a knee-jerk reaction.) There’s an old adage you and your shameless bretheran would be wise to learn: “You are entitled to your own opinions, but not your own facts.”

  15. AK on January 6th, 2014 9:32 PM

    Hey df, why the eff would Fox want to dump the UFC? Yes, FS1 is struggling, but the UFC is literally carrying the entire network (as low/off as they may be from the Spike/FX days). That makes absolutely zero sense. Yes, DFW announced it on ESPN, but why wouldn’t he take the opportunity to reach an audience 10x the size of UFC Tonight’s?

  16. BrainSmasher on January 6th, 2014 9:42 PM

    Does that bother you Random Gay Dude? How about you worry about answering AK and explaining your ignorant comments?

  17. AK on January 6th, 2014 11:39 PM

    He’s usually so reliable with his “UFC is dead forever” retorts, but I’ve had to call him out on his convenient absence multiple times this time. Can’t be too surprised I guess — this is someone who said monopoly’s bad for business and regulations good. What else do companies love, getting reamed by taxes? Yes, that must be why countless US corporations spend so, so much energy trying to find this tax loophole and that loophole with their “overseas operations” and such http://www.forbes.com/sites/beltway/2013/05/21/the-real-story-about-apples-tax-avoidance-how-ordinary-it-is/. Ah, the dogma of “social justice” and complete disregard/disdain for math and history… it must be great perpetually viewing the world through the innocent/ignorant eyes of an infant. Innocence is good. but reality’s sort of an important part of life as well.

  18. Diego on January 7th, 2014 10:33 AM

    AK,

    Anyone who thinks “USA” chants are racist and xenophobic is a moron. “USA” just sounds too good not to chant. And pride in one’s nation does not necessarily denote aggressiveness towards others. So I think we agree there.

    As for monopolies, it is the nature of enterprise to seek them and it is the nature of consumers to prevent them. That’s the constant struggle whether the enterprise is seeking to control communications (Carlos Slim in Mexico), labor (the UAW), basic foodstuffs (the United Egg Producers), or MMA (allegedly the UFC).

    I don’t think the UFC has a monopoly because other organizations are still able to operate freely, and the UFC is not preventing anyone from operating, or from making a profit. It’s just a tough industry in which to make money.

  19. Sampson Simpson on January 7th, 2014 12:13 PM

    What about the $800 million loan the UFC owes due this year?

  20. Random Dude on January 7th, 2014 1:01 PM

    AK, if you are anything you are certainly funny. You already got a reply from me yet you want to keep stalking me from post-to-post.

    Like saladathief said in the original article, no point in explaining things to a 14-year old. Once I realized I have been fooled I don’t get fooled again like the great George Bush once said. I don’t waste time explaining things to people who are not seriously listening or discussing. If someone serious about discussing something asks me the same question I would answer, that person is not you. I’m done discussing things with a kid like you. It’s pointless. Keep it up though, you are more entertaining than BrainSmasher.

  21. AK on January 7th, 2014 1:25 PM

    Right, Diego, glad we can agree. And regarding monopolies, even IF the UFC were one, it wouldn’t be such a bad thing. Monopolies are bad for virtually every industry, but sports appear to be the exception. Would it be better if the talent was split once again between the USFL and NFL, ABA and NBA, Negro Leagues and MLB? No — the only people it’d hurt are those players who wouldn’t be able to make a team due to the fewer roster spots. But otherwise, it’s good for the fans, good for the company, and good for the players/fighters.

    Who are you talking to Simpson/Random Dude?

  22. AK on January 7th, 2014 1:32 PM

    Ha, pathetic. You didn’t address ONE point I made. That is one of the most transparently pathetic cop-outs I’ve seen in a long time. You obviously have no answers so just admit you’re wrong. I would have so, so much respect for you then — don’t continue to stand by statements that are illogical and folly on countless levels. Really, what are you afraid of? Me gloating? No, I’m above that. Like I said, I would have so much more respect for you and your opinions. But just calling names and saying my points are “not serious” are pathetic and preposterous. Anyone who’s been following this discussion would agree. You’re usually so quick with the replies, but not this time. Wonder why.

  23. Sampson Simpson on January 7th, 2014 4:28 PM

    AK = Labia Minor

  24. dfdfdfdf on January 7th, 2014 9:17 PM

    Hey df, why the eff would Fox want to dump the UFC? Yes, FS1 is struggling, but the UFC is literally carrying the entire network (as low/off as they may be from the Spike/FX days). —————————————————————————————————————————— The entire channel is going to get canned….or at least massive changes or restructuring b/c FS1,FS2 are struggling.. I can’t see that NOT impacting the UFC as the UFC is a big part of that channel…

    That makes absolutely zero sense. Yes, DFW announced it on ESPN, but why wouldn’t he take the opportunity to reach an audience 10x the size of UFC Tonight’s? ————————- FOX pays UFC $90M per year…

  25. AK on January 7th, 2014 10:30 PM

    You forgot to post as Random Dude on the last one Simpson. Truly, truly pathetic and a mental midget. You’ve officially lost all credibility and all can see you for what you are — a mental midget troll with zero real-world knowledge.

  26. Random Dude on January 8th, 2014 1:30 PM

    I act online the same way I do in real life. Just because you want to talk to me doesn’t mean I want to or will talk to you. Sales people in malls and scammers in tourist places like the Las Vegas strip hate my attitude too. I’ll be sure to add you the list.

    “Like I said, I would have so much more respect for you and your opinions.”

    I guess I will just have to figure out someway to make it through life without your respect.

  27. AK on January 8th, 2014 7:20 PM

    You have absolutely zero answers, so you resort to juvenile name-calling and “uuuuu I’m to smart to answer that” tactics. Talk about shameless and pathetic.

  28. BrainSmasher on January 8th, 2014 7:37 PM

    “FOX pays UFC $90M per year…”————————————

    What is your point? The UFC just used ESPN to push UFC 168 and it allowed the UFC prelims ON FS1 to killer ratings. Not to mention it boost all the other programs. Also, in case you didn’t know, there is a reason why Sportscenter shows highlights for many other networks and list the copyrights at the end of the show. They could easily prevent them from using those clips. But it is good business to reach another networks fan base.

  29. Random Dude on January 8th, 2014 9:20 PM

    “What is your point? The UFC just used ESPN to push UFC 168 and it allowed the UFC prelims ON FS1 to killer ratings. Not to mention it boost all the other programs. Also, in case you didn’t know, there is a reason why Sportscenter shows highlights for many other networks and list the copyrights at the end of the show. They could easily prevent them from using those clips. But it is good business to reach another networks fan base.”

    I think his point is that it is something that the UFC did not do before and the reason they are doing it now is due to decreasing popularity. When the UFC was considered “the fasting growing sport” and booming everywhere, they didn’t care about being on ESPN or sharing highlights, they didn’t need to in order to get lots of PPV buys and ratings. Now it seems things are different (worse) which is what I believe dfdfdfdf is pointing out.

  30. Random Dude on January 8th, 2014 9:26 PM

    “You have absolutely zero answers, so you resort to juvenile name-calling and “uuuuu I’m to smart to answer that” tactics.

    I don’t think I am too smart, I think you are being obtuse. It might be purposeful or it might be how you actually are as a person. I don’t know and I don’t care, the end result is the same. In either case, it is a waste of time to explain things to such people. My previous post explaining some things about boxing to you was a waste of time on my part. Even this explanation is too much, congratulations, you got me again.

    “Talk about shameless and pathetic.”

    You are absolutely right, I’ll be sure to bring it up with my therapist. More please, you are helping me become a better person.

  31. edi on January 9th, 2014 12:17 AM

    I would much rather rip my shoulder or knee up in Canada or Australia than the USA if I did not have money.

  32. AK on January 9th, 2014 2:19 AM

    See, you proved my point for like the 10th time this past week. You are so, SO very willing to oblige on the long, drawn-out answers when you think you have a semi-coherent point. Other times? “You’re a dumb poo poo head, you doo doo stalker. Businesses hate money and love taxes. That’s fact, poo poo head. I just explained why by calling you a poo poo head again.”

  33. AK on January 9th, 2014 2:35 AM

    Everyone here (even the most casual of users) has seen you “waste your time” a thousand times — seeing you say the same things for the hundredth time? This time? “You’re a dumb poo poo head, you doo doo stalker. Businesses hate money and love taxes. That’s fact, poo poo head. I just explained why by calling you a poo poo head again.”

  34. Random Dude on January 9th, 2014 5:42 PM

    Keep going AK, you are doing great.

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