Frequently Asked Questions

Is there a limit or cap on Prolia® Co-pay Program benefits?

Yes, the Prolia® Co-pay Program will reimburse an eligible patient's combined total deductible, co-pay and/or co-insurance requirements up to $1,500 per calendar year for Prolia® (denosumab). The patient is responsible for costs above this amount.

Why are uninsured, cash-paying patients not eligible for the Prolia® Co-pay Program?

The Prolia® Co-pay Program is intended to help commercially insured patients cover the cost of their co-pay or deductible for Prolia® (denosumab). Uninsured patients requiring assistance may be directed to The Amgen Safety Net Foundation at 1-888-SN-AMGEN (1-888-762-6436) to request assistance. The foundation helps support uninsured patients and certain underinsured patients with financial need who do not have coverage for Prolia® or other Amgen medications, and are not eligible for other support options such as Medicare or Medicaid.

Are there financial assistance options available to people on Medicare or Medicaid?

Amgen Assist® can refer patients, as a courtesy, to independent co-pay foundations. Provided through independent charitable patient assistance programs, eligibility in these foundation programs is based on criteria established by the charity. Amgen has no control over independent, third-party programs. For more information, contact Amgen Assist®at (866)264-2778.

Is annual re-enrollment in the Prolia® Co-pay Program necessary?

Once your office is enrolled in the Program, there is no need to re-enroll. However, Prolia® Co-pay Program benefits renew every January and patients need to re-verify their eligibility on a yearly basis. Once eligibility has been confirmed, patients will be sent their new Prolia® Co-pay Program card. Annual benefits remain in effect through December 31st, [2017]. At that time, participants will need to re-verify their benefits by logging into or calling 1-844-369-9962 to ensure they still meet the program's eligibility criteria. Once benefits are re-verified and eligibility reconfirmed, the calendar year maximum benefits will automatically reset.

Can the Prolia® Co-pay Program MasterCard® be used with mail order and specialty pharmacies?

Yes, the Prolia® Co-pay Program MasterCard® can be used at pharmacies. Patients should provide the RxBIN number and member ID that is printed on the card when filling their prescription.

Can patients use their Co-pay Card for Prolia®-related office visits?

No. The Prolia® Co-pay Program covers out-of-pocket medication costs for Prolia® only. It does not provide support for supplies, procedures, or any physician-related services associated with Prolia®, including office visits or administration of Prolia®.

Does the Explanation of Benefits (EOB) have to be faxed after each dose?

Ongoing eligibility in the program is contingent on submission of the patient's Explanation of Benefits (EOB) within 180 days of each and every swipe of the Prolia® Co-pay Card. To submit EOB and other relevant documentation, please fax 1-844-369-9961 or mail to:
The Macaluso Group
at 100 Passaic Avenue, Suite 245
Fairfield, NJ 07004
ATTN: Prolia Co-pay Program.