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Key takeaways
Linzess is a brand-name prescription drug that treats chronic constipation.
Most Blue Cross Blue Shield insurance plans cover Linzess and include it as a preferred drug on the formulary, but individual BCBS plans differ. You may need to contact your provider directly to confirm coverage.
Without insurance, Linzess costs around $750 for a 30-day supply.
Most 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 constipation in adults and some children and adults with irritable bowel syndrome with constipation (IBS-C). It’s a guanylate cyclase-C agonist that helps people pass bowel movements more quickly and easily while reducing discomfort. Most 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.
In general, though, commercial insurance companies like BCBS usually 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 classify it as a specialty drug or list it under plan exclusions (if it’s prescribed for an off-label use).
A formulary is a list of covered drugs that an insurance plan agrees to pay for. 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 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 doctor will need to diagnose you with one of the conditions Linzess is used 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 3 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 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 $750 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, most 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.
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:
- 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).
- 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.
- 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.
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.
How to save on Linzess
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 $750 to around $500. There are also other ways to save money on Linzess, regardless of your prescription drug coverage.
- The Blue Cross and Blue Shield system, Blue Cross Blue Shield Association (2025)
- Linzess is widely available on commercial plans with few restrictions, AbbVie (2024)
- State Medicaid preferred drug lists, KFF (2019)
- Amitiza® (lubiprostone), Linzess® (linaclotide), Trulance™ (plecanatide) prior authorization program summary, Blue Cross Blue Shield of Alabama (2018)
- Blue Cross Blue Shield of Michigan Blue Care Network prior authorization and step therapy coverage criteria, Blue Cross Blue Shield of Michigan (2024)
- Cost & savings, AbbVie (2025)