Program Details: The Prolia® Co-pay Program provides financial support for eligible commercially insured patients. The program does not provide support for supplies, procedures, or any physician-related services associated with Prolia®. For eligible patients, the program covers the amount of OOP cost for Prolia® that exceeds $25 for each dose, up to a maximum benefit of $1,500 per patient, per calendar year. Patient is responsible for costs above this amount. Patient card is reset every January 1. Patients need to re-verify their eligibility on a yearly basis.
Why Enroll Your Office in the Prolia® Co-pay Program?
When your office registers for the Prolia® Co-pay Program, you can help your eligible patients enroll, too. Once they're enrolled, they can save on each dose of Prolia®, download and submit essential forms, and re-enroll every year on the Prolia® Co-pay site.
1. Register Your Practice
After completing online enrollment, call 1-844-369-9962 to register the credit card terminal your office will use to process Prolia® Co-pay Cards. If your office is already registered, you can move on to step 2.
2. Help Identify Eligible Patients
Help identify which of your patients may be eligible for the Prolia® Co-pay Program prior to initiating treatment.
3. Help Patients Enroll
Help your eligible patients register for the Prolia® Co-pay Program by assisting them with the enrollment process and the Privacy Notice and Patient Authorization Form (options online, by phone at 1-844-369-9962, or by fax 1-844-369-9961). Once completed, your patient's Prolia® Co-pay Card will be activated.
Remember that patients need to enroll and agree to the Privacy Notice and Patient Authorization themselves.
4.Submit Essential Forms
To submit an Explanation of Benefits (EOB) and other relevant documentation, click here. ®.
5.Use Co-pay Card
Swipe patient's card at visit for the appropriate deductible, co-insurance, or co-payment for one syringe of Prolia*The Prolia® Co-pay Program does not cover costs related to the office visit or administration of Prolia®.* Other restrictions may apply.