Is Physicians Mutual Dental Insurance Good?

Physicians Mutual dental insurance covers over 350 procedures and allows their members to choose any dentist. Their plans have no annual maximums, no deductibles, and short waiting periods.

Physicians Mutual offers four dental plans with monthly premiums from $30 to $54.

Although their Premier plan’s premium is a little pricey, its comprehensive coverage for preventive, basic, and major services is worth it.

To offer a complete overview of Physicians Mutual’s offerings, I’ll compare it with Delta Dental, another popular dental insurance provider, taking into account factors such as coverage, cost, and waiting periods.

Let’s jump right in.

Physicians Mutual: Pros + Cons

Pros:

• Comprehensive coverage: Physicians Mutual offers various dental coverage options, including preventive care, basic procedures, and major services.
• No annual maximum: One huge advantage is that there is no annual maximum limit on benefits, which allows policyholders to receive necessary treatments without worrying about hitting a cap.
• No network restrictions: Policyholders are free to visit any dentist they choose, as the insurance does not require members to stick to a network of providers.

Cons:

• Waiting periods: Certain major procedures may have waiting periods, which might be inconvenient for those needing immediate dental care.
• Limited coverage for major procedures: Some major procedures might only be partially covered, leaving policyholders with out-of-pocket expenses.

In a nutshell:

Physicians Mutual dental insurance covers over 350 procedures with no annual or lifetime maximum benefits, and patients can choose any dentist.

However, some drawbacks include mixed customer satisfaction regarding premium increases, the claims process, and a 12-month waiting period for major care.

Physicians Mutual Dental Plans

Physicians Mutual offers comprehensive dental coverage options – all without deductibles. 

Plan Offerings

Physicians Mutual offers four levels of coverage:

#1.  Economy Plus: A budget-friendly option at $30.10 per month.

#2.  Standard Plus: A cost-effective plan priced at $37.80 per month.

#3.  Preferred Plus: The most popular choice at $46.75 per month, providing the highest payouts for covered dental services.

#4.  Premier: priced at $54.50 per month, stands out by offering extensive coverage designed to address major dental services. This plan covers significant procedures such as crowns, bridges, and dentures.

Let’s break down each plan and its benefits.

Economy Plus Plan

The Economy Plus Plan covers basic dental services like exams and cleanings. This plan is ideal for individuals who want to maintain their overall oral health with a low monthly premium.

Coverage breakdown:

• Cleanings – 100%
• Routine Exams – 100%
• Dental X-rays – 100%
• Fillings for cavities – 25%
• Minor oral surgery procedures and sedation – 25%
• Simple tooth extractions – 25%
• Root canals – 25%
• Crowns – 25%
• Dentures – 25%

Standard Plus Plan

The Standard Plus Plan is perfect for those seeking a comprehensive coverage package that includes preventive care and major services. This plan offers a higher reimbursement rate for major services compared to the Economy Plus Plan.  

Coverage breakdown:

• Cleanings – 100%
• Routine Exams – 100%
• Dental X-rays – 100%
• Fillings for cavities – 40%
• Minor oral surgery procedures and sedation – 40%
• Simple tooth extractions – 40%
• Root canals – 40%
• Crowns – 40%
• Dentures – 40%

Preferred Plus Plan

The Preferred Plus Plan is the most popular among Physicians Mutual’s coverage options due to its high payouts and extensive coverage. It helps cover a range of dental procedures, including preventive, basic, and major services.

Coverage breakdown:

• Cleanings – 100%
• Routine Exams – 100%
• Dental X-rays – 100%
• Fillings for cavities – 55%
• Minor oral surgery procedures and sedation – 55%
• Simple tooth extractions – 55%
• Root canals – 55%
• Crowns – 55%
• Dentures – 55%

Premier Plan

The Premier Plan is Physicians Mutual’s most comprehensive coverage option and is also the priciest at $54.50 per month. 

Coverage breakdown:

• Cleanings – 100%
• Routine Exams – 100%
• Dental X-rays – 100%
• Fillings for cavities – 70%
• Minor oral surgery procedures and sedation – 70%
• Simple tooth extractions – 70%
• Root canals – 70%
• Crowns – 70%
• Dentures – 70%

Network and Dentist Accessibility

Physicians Mutual has a comprehensive network of dental care providers. Policyholders can choose any dentist, including both in-network and out-of-network providers.

This is a great perk for those who have established relationships with their dentists or live in areas with fewer dental providers.

In-Network Provider Benefits

The primary advantage of using in-network providers is the potential for lower out-of-pocket costs. In-network providers accept pre-negotiated rates, typically lower than their usual charges.

Additionally, claims with in-network providers are typically processed more efficiently, saving patients time and hassle. This can be particularly beneficial for those who need regular dental work, as it can streamline the process.

Out-of-Network Flexibility

Physicians Mutual dental insurance gives its members the freedom to seek care from out-of-network dentists.

But, it’s worth noting that patients opting for out-of-network providers are generally reimbursed at a rate reflecting the insurer’s standard fee schedule, not necessarily the dentist’s actual charges. This can lead to higher out-of-pocket costs.

Other factors include an annual maximum benefit for out-of-network care and potential waiting periods for certain procedures. So, while the flexibility is a plus, the financial implications may outweigh the benefits.

Physicians Mutual vs. Delta Dental Plans

When comparing Physicians Mutual’s dental plans with those of a leading provider like Delta Dental, several factors must be considered, including coverage, annual maximums, and waiting periods.

Physicians Mutual Economy Plus Plan vs. Delta Dental Basic Plan

• Physicians Mutual Economy Plus:
  • Coverage: 100% coverage for preventive services such as cleanings, exams, and x-rays. 25% coverage for basic services like fillings and extractions. Major services are covered at 25%.
  • Annual Maximums: None.
  • Deductibles: None.
  • Waiting Period: Typically, there are no waiting periods for preventive services.
• Delta Dental Basic:
  • Coverage: 100% coverage for preventive care. 80% coverage for basic services after a 6-month waiting period.
  • Annual Maximums: Typically, around $1,000 per year.
  • Deductibles: Typically $50 per person, with family deductibles varying.
  • Waiting Period: 6 months for basic services.

You just can’t beat Physicians Mutual’s Economy Plus Plan. Sure, Delta Dental covers 100% for preventative care, too, but Physicians Mutual is clearly a better option with no annual maximums, no deductibles, and no waiting periods.

Physicians Mutual Premier Plan vs. Delta Dental Premier Plan

• Physicians Mutual Premier:
  • Coverage: 100% coverage for preventive services. 70% coverage for basic and major services.
  • Annual Maximums: None
  • Deductibles: None.
  • Waiting Period: No waiting periods for preventive and major services.
• Delta Dental Premier:
  • Coverage: 100% coverage for preventive care. 80% coverage for basic services and 50% for major services after a 6-month waiting period. Includes coverage for more complex procedures like crowns and root canals.
  • Annual Maximums: $2,000.
  • Deductibles: $50 per person, $150 per family.

Physicians Mutual’s Premier Plan offers a higher reimbursement rate for major services than Delta Dental, and again, there are no deductibles or annual maximums.

Bottom Line

I hope I’ve provided valuable insights into Physicians Mutual dental insurance by weighing the pros and cons to help you determine if it’s the right fit for you.

Physicians Mutual’s dental options are great—no annual maximums, no deductibles, and mostly no waiting periods are tough to beat. The Premier plan’s premium might be a bit higher than Delta Dental, but the comprehensive coverage for all your preventative, basic, and major dental needs makes it worth it.

As with any insurance, it’s important to thoroughly research and understand your coverage before enrolling in a plan.

For example, if you have ongoing dental issues or require frequent procedures, a plan with higher coverage and lower out-of-pocket costs may be more beneficial.

On the other hand, if you only require routine cleanings and check-ups, a basic plan with lower premiums may be the right fit for you.

Sources:  Physicians Mutual  |  Delta Dental

FAQs

• Is Physicians Mutual available in every state?

  Physicians Mutual serves all states except for Massachusetts, Minnesota, Montana, New Hampshire, New Mexico, Rhode Island, Vermont, and Washington.

• Who accepts Physicians Mutual dental insurance?

  Physicians Mutual has a large network of over 500,000 providers, including dentists and other healthcare professionals.

• Is dental insurance from Physicians Mutual worth it?

  While Physicians Mutual Dental Insurance may not be the top choice for dental insurance, it is still a solid pick and has several plan options.