Mercury Amalgam Removal Insurance Coverage

Does my insurance pay for removal of mercury amalgam fillings?

If insurance companies covered the cost of amalgam removal, they would be admitting that mercury is poisonous to patients. That would mean that they would have to pay to remove everyone’s amalgams, and that cost would be enough to break even the largest of insurance companies. Remember, what are insurance companies in business for?

That said, however, the majority of dentistry performed is the removal  and replacement of cracked, decayed or otherwise non-serviceable fillings.   Dental insurance normally covers replacement of this type of fillings, whether they are mercury amalgam or white composite fillings.  Insurance  covers replacement pursuant to the contract whether the fillings are replaced with another filling, or if very large, with an onlay or crown.

Due to the additional technique sensitivity in placement of composite fillings there is usually a higher fee charged  than for mercury amalgam fillings.  Often, insurance companies reduce the fee charged for a posterior composite filling to that allowed for a mercury filling.

For example,  a $ 325  filling charge may be reduced to $ 240 (just a guess) and THEN the insurance company pays their percentage (whether 50 %, 70 % or 80 %, depending on your contract).  You then also, in addition to your co-payment, pay the amount above their allowed [reduced] amount for that procedure, in this example, 325 – 240 =  $ 85 ( plus your co-payment on $ 240).

Typically, insurance companies pay from $ 1000 to $ 1500 per calendar year, depending on your contract.    Let’s assume, for an example, that your annual dental benefit is $ 1000.  Lets also assume that your carrier will not reduce the fee allowed for composites to the amalgam fee (although they almost always do).   Then you could have $ 1250 worth of dental fillings done and at 80 % benefit, your carrier would pay $ 1000 and you would pay $ 250.

Fillings that are not damaged or decayed may not be covered by insurance whether the choice to remove them is strictly for cosmetic reasons,  for mercury content or the desire to not have metal in the mouth.

How much does it cost to have a mercury  amalgam filling replaced?

Tooth colored composite fillings range in price from approximately  $ 250 to $ 550 depending on size.  If a tooth has extensive decay or is cracked from the amalgam filling and / biting forces, a porcelain / ceramic onlay may be recommended to increase durability.  You may still choose to have a composite filling, even if the porcelain is recommended.   While the porcelain / ceramic onlay (or crown)  may be expected to last much longer than a composite  filling, you may get a number of years of service from the filling.