Register for the Prolia® Co-pay Program

To register, just follow these 4 steps.

1. Check Your Eligibility

After you answer a few "Yes" or "No" questions, we'll determine if you're eligible for the Prolia® Co-pay Program.

2. Enter Personal Information

You'll be asked to provide personal information, such as your name, address, and birth date.

3. Enter Insurance Card Information

Enter your commercial Insurance information. You'll need to have your commercial insurance card to fill out this section. If you have your Prolia® Co-pay Card information available, you can enter it here as well.

4. Enter Doctor Information

You'll need to enter your doctor's first and last name, as well as the city and state of his/her office.

Rather Enroll By Phone?

Call the Prolia® Co-pay Program at