Does Delta Dental Cover Fillings? What to Know About Composite, Amalgam, and Coverage Rules

By Dr. Mason Haddow

Yes, Delta Dental covers fillings, but your cost depends on the type of filling, the location of the tooth, and your specific plan. Not all fillings are created equal in the eyes of insurance, and neither are dental plans.

Fillings are one of the most common dental procedures and one of the easiest to misunderstand when it comes to coverage. In this article, we’ll explain what Delta Dental typically covers, what it might not, and how to get the most value from your plan.

Key Takeaways

✔ Fillings are covered by Delta Dental as basic restorative services
✔ PPO plans usually cover 70–80 percent after deductible
✔ Composite fillings on molars may cost more if downgraded to amalgam
✔ DHMO plans use fixed copays and may limit back-tooth composites
✔ Premier Image Dentistry offers in-network expertise and financing for all filling types

What Are Dental Fillings and When Are They Needed?

Dental fillings are used to treat cavities, small cracks, and surface damage caused by wear. The sooner decay is caught, the easier and cheaper it is to fix. Delay it, and you’re looking at root canals or crowns instead.

Common materials used:

Amalgam (silver): Durable, lower-cost, usually for back teeth
Composite (tooth-colored): Aesthetic, often used for front or visible teeth
Ceramic or inlays: More cosmetic and costly, often not covered unless necessary

Types of Fillings and Dental Codes

Knowing these codes can help you understand your estimate or EOB (Explanation of Benefits):

D2140–D2161: Amalgam fillings
D2330–D2394: Composite fillings (1 to 4+ surfaces)
D2950+: Other types of restorations or buildups

Does Delta Dental Cover Cavity Fillings?

Yes, Delta Dental covers fillings under most PPO and DHMO plans. They’re considered basic restorative services.

PPO plans: Typically cover 70 to 80 percent of the cost after deductible
DHMO (DeltaCare USA): Use fixed copay amounts that vary by material and tooth

What matters most: tooth location, material choice, and your plan’s fine print.

Delta Dental PPO Plans: Coverage Breakdown

With a PPO plan:

Coverage is usually 70–80 percent after you meet your deductible
Amalgam fillings are generally covered without issue
Composite fillings may be downgraded to the cost of an amalgam if placed on molars
If you choose composite on a molar, you may pay the difference
Annual maximums (often $1,000–$2,500) still apply

DeltaCare USA (DHMO): What to Expect

DHMO plans work differently. Instead of reimbursement, you pay fixed copays per service.

Must use your assigned in-network provider
Copays for fillings range from $20 to $100
Composite fillings on front teeth are usually covered
Composite on back teeth may require an extra out-of-pocket fee

Always check your plan’s copay schedule to know what you’ll owe.

Are Tooth-Colored (Composite) Fillings Covered?

Yes, but with limits.

Front teeth and premolars: Typically covered for composite fillings
Molars: PPO plans may downgrade the benefit to amalgam, meaning you pay the difference for composite
If composite is medically necessary (e.g., allergy to metal), documentation helps

How Much Do Fillings Cost With and Without Delta Dental?

Without Insurance:

Amalgam: $100 to $200
Composite (front): $150 to $250
Composite (back): $200 to $350

With Delta Dental PPO:

After deductible and coverage, expect to pay $30 to $100 per filling

With DeltaCare USA:

Copay: Typically $20 to $100, depending on tooth and material

When Might a Filling Not Be Covered?

If it’s considered cosmetic only, like changing the color of a front tooth
If it’s a replacement too soon after a previous filling (some plans require a 2–5 year wait)
If you go out of network on a DHMO plan
If your provider submits incorrect codes or lacks documentation

Tips to Maximize Your Delta Dental Filling Coverage

Choose in-network dentists to avoid surprise fees
Ask your provider about downgrade clauses for composites on back teeth
Request a pre-treatment estimate before getting multiple fillings
Use your FSA or HSA for tax-free payment of uncovered portions
Get regular checkups so you catch decay early and avoid costly repairs

What If Your Filling Isn’t Covered or Fully Paid?

Here are your options incase your filling isn’t covered or fully paid:

1. Ask for a Pre-Treatment Estimate

If the work hasn’t been done yet, your dentist can submit a pre-treatment estimate to Delta Dental. This gives you a breakdown of what’s covered, what’s not, and how much you’ll owe. It’s one of the best ways to avoid financial surprises.

2. Appeal or Resubmit the Claim

Sometimes coverage is denied due to missing documentation or incorrect coding. Your dentist can help resubmit the claim with X-rays, clinical notes, or a letter of medical necessity. If it was downgraded from composite to amalgam, ask your provider to justify why composite was medically needed.

3. Negotiate or Opt for Alternative Materials

If cost is the concern, ask your dentist about using amalgam instead of composite in back teeth. It may not be as aesthetic, but it’s usually fully covered. Some practices also offer sliding scale pricing or alternate materials that are durable and more affordable.

4. Use a Payment Plan or Dental Financing

Premier Image Dentistry provides flexible in-house payment options and works with third-party financing like CareCredit. This makes it easier to pay over time if your insurance doesn’t cover the full amount.

5. Consider a Dental Discount Plan

If you’re without insurance or your plan consistently under-delivers, dental discount plans can offer 20–60 percent off restorative procedures including fillings. These are not insurance but can be a smart option when used strategically.

6. Time Your Treatment

If you’re close to maxing out your benefits for the year, it may be wise to wait until your plan resets. Talk with your dentist about prioritizing urgent fillings now and postponing others until the new benefit year begins.

Being proactive about your coverage and options can make a big difference in what you pay—and how well your teeth are protected.

Looking for Fillings in Atlanta, GA?

At Premier Image Dentistry, we provide:

Composite and amalgam fillings using modern, minimally invasive techniques
Help navigating Delta Dental PPO and DHMO plans
Pre-treatment estimates and upfront pricing
Flexible payment plans to suit your budget

Schedule your visit today and let us handle your smile and your savings.

Final Thoughts

Delta Dental does cover fillings, but not all fillings are covered equally. Your cost depends on the material, location of the tooth, and your plan type.

PPO plans cover a percentage, while DHMO plans offer fixed fees. And composite fillings on molars? They’re often partially covered unless you choose the budget-friendly option.

The best move: know your benefits, ask questions, and let a dental team like ours help you make the smartest financial decision for your health.