Step 1: Confirm Eligibility

Since you've been prescribed Prolia® by your doctor, you may be able to participate in the Prolia® Co-pay Program and save money on your medication. Please answer the following questions to see if you are eligible, then click Continue. All fields are required.

Please answer the questions below to see if you are eligible for an Prolia® Co-Pay Card.

I am 18 years of age or older and live in one of the 50 United States or a US territory.
What type of insurance do you use to pay for your Prolia® prescription at the doctor's office? (please select one option)

Commercial insurance (e.g., self-purchased or through an employer)?

Government-provided (e.g., Medicare Part D, Medicaid)?

I don't have insurance

I don't know

Health insurance you or a family member purchased and/or receive through an employer, healthcare exchange, or a commercial plan through the Federal Employee Health Benefits (FEHB) program.
Includes Medicare Part D, Medicaid, TRICARE, Department of Defense, or Veterans Affairs programs.
Are you eligible for Medicare but receive prescription drug coverage from a former employer, union or welfare plan?

By checking this box, I agree that I read, understand and accept the Terms and Conditions of the Prolia® Co-Pay Program.