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Does Blue Cross Blue Shield cover Linzess?

Wondering if your BCBS plan covers Linzess? Find out how coverage works, typical copays, step therapy rules, and savings tips for this prescription drug.
Rx bottle with an exclamation point: Does Blue Cross Blue Shield cover Linzess?

Key takeaways

  • Linzess is a brand-name prescription drug that treats chronic constipation.

  • Many Blue Cross Blue Shield insurance plans cover Linzess and include it as a preferred drug on the formulary, but individual BCBS plans differ.

  • Without insurance, Linzess costs around $706 for a 30-day supply, but many people with BCBS coverage of Linzess can pay $50 or less per month for their prescription.

Linzess (linaclotide) is a brand-name prescription medication approved by the FDA to treat irritable bowel syndrome with constipation (IBS-C) in adults and children 7 years and older, functional constipation in children 6 years and older, and chronic idiopathic constipation in adults. It’s a guanylate cyclase-C agonist that helps people pass bowel movements more quickly and easily while reducing discomfort. Many commercial insurance plans, including Blue Cross Blue Shield (BCBS), cover Linzess for the treatment of constipation. Still, there may be exceptions or other things to know before you get coverage.

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Does Blue Cross Blue Shield cover Linzess?

Blue Cross Blue Shield (BCBS) is an association of insurance companies that provides coverage to millions across the U.S. Most states have their own BCBS company, and each one operates differently, meaning drug coverage rules and pharmacy benefits can vary by state and plan.

In general, though, commercial insurance companies, including many BCBS plans, often cover Linzess. According to the manufacturer’s formulary status tool, a review of BCBS plans across different states shows Linzess is often listed as a preferred brand medication. However, some plans may list it under plan exclusions or require additional steps for coverage.

A formulary is a list of covered drugs that an insurance plan agrees to pay for, and their pricing tiers. When a drug is labeled as preferred, it generally means it’s covered at a lower cost and may be recommended before non-preferred alternatives. In some cases, your plan may require healthcare professionals to prescribe a preferred drug first before covering other similar options.

In other words, preferred drugs typically have the most coverage under insurance plans. (Again, state-by-state or specific plan coverage will vary, and your BCBS company may place Linzess in a different coverage tier). No matter what type of drug Linzess is categorized under, you may still need to meet some requirements before BCBS covers it.

  • Diagnosis: Your prescribing healthcare provider will need to diagnose you with one of the conditions Linzess is FDA approved to treat (like chronic constipation or IBS-C) for your plan to cover the drug. Your insurer may also require you to have had symptoms for at least three months.
  • Step therapy: Some BCBS plans may require evidence of step therapy before they cover Linzess. Step therapy means you need to try other treatments first, such as Miralax, stimulant laxatives, or lifestyle changes like increasing fiber and water intake, before your plan will approve Linzess. According to Dana Manning, Pharm.D., RD, LDN, associate professor of pharmacy practice at Wilkes University in Pennsylvania, many people with IBS-C may have already tried these options without improvements in symptoms. Whether your provider can prescribe Linzess immediately without step therapy depends on your specific plan.
  • Quantity limits: Some BCBS plans may limit the amount of Linzess you can get at once or limit the number of pills filled per month. These limits are often based on FDA-approved dosing guidelines or other criteria.
  • Prior authorization: Some drugs require a written explanation from your provider about why a medication is needed before your insurer will cover it; this is called prior authorization. This varies by plan, so it’s best to check with your insurer to find out if prior authorization is required.

How much does Linzess cost?

There is no generic form of Linzess, so if your provider prescribes it, you’ll receive the brand-name drug. As a result, Linzess may be more expensive than other medications that are available as generic drugs, especially if you don’t have insurance coverage. Without insurance, the average retail price of Linzess is around $706 for a 30-day supply of 145 mcg capsules.

How much does Linzess cost with Blue Cross Blue Shield?

If you’re on a family or employer-sponsored benefit plan, your prescription drug benefit will determine how much you pay. Linzess is a brand drug that may fall under higher copay tiers.

Still, many eligible people with commercial insurance like BCBS can have a copay of around $30 when using the manufacturer’s savings card. Your copay may be higher or lower than that, but per AbbVie, more than 90% of people with commercial insurance pay $50 or less for their monthly Linzess prescription when using this savings card along with insurance.

How to check whether your Blue Cross Blue Shield plan covers Linzess 

If you’re wondering whether your BCBS plan covers Linzess, there are a few ways you can check:

  1. Use the Linzess formulary tool: On the Linzess website, you can input your zip code and select the “Commercial” filter for insurance type, then scroll down to find your local BCBS company to see how it categorizes Linzess on your formulary. As noted above, most drugs marked as preferred will be covered, but you should always check with your insurer directly to ensure your pharmacy benefits (or need to know exactly what your copay will be).
  2. Refer to your member documents: Health insurance companies usually send out packets of information each year with details about your coverage. If you have a member account with BCBS, you can also log in and access your plan or benefit information online. You may also be able to see what tier Linzess is placed on in your formulary. To do this, you can log in to your secure member account and navigate to the formulary. 
  3. Call your BCBS provider: The customer service number is often found on the back of your member ID card. Call your BCBS insurer and ask if drug coverage for Linzess is provided under your specific health plan. If you need help, TTY and language assistance lines are also listed on your card.
  4. Send a prescription to the pharmacy. You can also ask your healthcare provider to send a Linzess prescription to your preferred pharmacy. The pharmacy staff can process the claim through your insurance and let you know if the medicine is covered, or if additional steps (such as prior authorization) are required.

If you have Medicare, your plan’s Part D formulary will determine whether Linzess is covered. Medicare coverage can differ from commercial insurance, so always confirm your benefits before filling your prescription.

Medicaid plans vary by state, so if you have Medicaid, the best way to find out if Linzess is covered is to contact your specific state plan. 

What to do if insurance won’t cover Linzess

If your plan does not initially cover Linzess, ask your healthcare provider if they can complete a prior authorization (PA). Some plans may require this extra step before making a coverage decision. If the PA is denied, you can ask your provider if they can submit an appeal. If after all these steps, your Linzess Rx is still denied or is not affordable, check in with your healthcare provider. They may have suggestions for ways to save on Linzess without insurance, or they may decide to prescribe a different drug that may be more affordable and helpful for your condition. 

How to get Linzess without insurance

If you don’t have insurance coverage for Linzess, you may still be able to save money on the retail price. Using a SingleCare coupon at participating pharmacies may help lower the cost of Linzess from $706 to around $252, which will save you more than $450 per month. There are also other ways to save money on Linzess, regardless of your prescription drug coverage. 

The SingleCare prices in this article are the most accurate at the time of publishing in ZIP code 23666 as of Jun. 15, 2026. Prices vary by pharmacy. Visit our coupon page for updated drug prices at pharmacies near you.

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