I've dealt with a dealer that will sell generic gold and silver at spot and even at times under spot. Of course that is in person with cash and an established relationship. Let's just say he moves product incredibly fast and often has no inventory of generic because of this. Generally, the next person that walks in the door buys it. He's a retired fellow and I know that his margins are very small from speaking with him, he does it more for something to do a couple days a week. That's more of an exception to the rule though.
Typically, yes, there is a premium above spot and an extra premium for numismatic value.
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