Find out how much the shots cost out of pocket. My daughter was needing a medication, I forgot what it was, and it was not covered under her plan. I asked the pharmacist how much it cost, and the entire prescription was about $20.00. Find out what the out of pocket cost is.
Call the manufacturer of Prolia. Sometimes, they have things in place that they can't let people know about, unless they're denied coverage for it, or cancel due to not being able to afford the high cost.
It was that way with my Ibrance. When they first set me up, and she said my co-pay was over $3,000.00 a month, I about fainted. I told her to cancel, since there was NO WAY I could afford that. She told me to stay on the phone. In a minute she returned, and asked me a few questions, then told me I qualified for a program that would pick up most, if not all of the co-pay. She explained the most I would pay out of pocket was $5.00. She submitted my info, and I don't pay any co-pay.
When there are multiple manufacturers of a similar medication with the same active ingredient(s), but varying inert ingredients, each of the insurance companies will negotiate a deal with one of them. Often times, when a person is an exception, and can't tolerate that particular brand of medication due to one of the inert ingredients, they act like that's just too bad, and nothing can be done. Sometimes it's worth the phone call, and things can be worked out nicely.
BTW, see if Reclast is an option.
Yea they tried with my ibrance. Medicare denied it, the doc resubmitted it and they agreed to pay all of it for 2 years.