{"id":635729,"date":"2026-03-23T19:54:24","date_gmt":"2026-03-23T23:54:24","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=635729"},"modified":"2026-03-27T13:32:25","modified_gmt":"2026-03-27T17:32:25","slug":"does-medicaid-cover-linzess","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/does-medicaid-cover-linzess\/","title":{"rendered":"Does Medicaid cover Linzess?"},"content":{"rendered":"

Just ask the 25-45 million US adults who have <\/span>irritable bowel syndrome<\/span> or the approximately 35 million who have <\/span>chronic idiopathic constipation<\/span> (CIC): It can make life a challenge. Fortunately,<\/span> Linzess<\/span><\/a> (linaclotide) can help, treating the abdominal pain, bloating, and constipation associated with <\/span>IBS-C<\/span> or CIC\u2014but those benefits cost money. The specific cost you might pay for <\/span>Linzess<\/span> depends on your insurance coverage, your reason for taking it, and other factors. If you have <\/span>Medicaid<\/span>, you may receive some assistance paying for it.<\/span><\/p>\n

How much does <\/span>Linzess<\/span> cost?<\/span><\/h2>\n

For people purchasing<\/span> Linzess<\/span> without insurance coverage<\/span><\/a>, Medicare, or <\/span>Medicaid<\/span>, the average cost is around $730 for 30, 145 <\/span>mcg<\/span> capsules. That price isn\u2019t static across the board, though. It can vary depending on the dosage, the size of the prescription (30 or 90 days), your location in the country, and even the pharmacy you use.<\/span><\/p>\n

Unfortunately, there\u2019s no<\/span> Linzess<\/span> generic<\/span><\/a> currently available, so even though generics might be a reliable way to save on many medications, they aren\u2019t an option here. There are generic versions of linaclotide in development, but they won\u2019t be available until 2029.<\/span><\/p>\n\t\t

\n\t\t\t

Save up to 80% on Linzess with SingleCare<\/p>\n\t\t\t

Different pharmacies offer different prices for the same medication. SingleCare helps find the best price for you.<\/p>\n\t\t\t

\n\t\t\t\t
\n\t\t\t\t\tLinzess 145 mcg (30 capsules)\t\t\t\t<\/div>\n\t\t\t\t
\n\t\t\t\t\t23666 - Hampton, VA\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t
\n\t\t\t\"Kroger\t\t\t<\/div>\n\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t$252.26\n\t\t\t\t<\/div>\n\t\t\t\t
\n\t\t\t\t\ti<\/span>\n\t\t\t\t\tPrice with signup<\/a>\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t
\n\t\t\t\tGet free coupon<\/a>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t
\n\t\t\t
\n\t\t\t\"Harris\t\t\t<\/div>\n\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t$252.26\n\t\t\t\t<\/div>\n\t\t\t\t
\n\t\t\t\t\ti<\/span>\n\t\t\t\t\tPrice with signup<\/a>\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t
\n\t\t\t\tGet free coupon<\/a>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\tSee Linzess prices at all pharmacies<\/a>\n\t\t<\/div>\n\n\t\t\n

Does <\/span>Medicaid<\/span> cover <\/span>Linzess<\/span>?<\/span><\/h2>\n

The short answer is yes,<\/span> Medicaid<\/span> may cover <\/span>Linzess<\/span><\/a>. The longer answer is that coverage might vary by state. Since <\/span>the federal and state governments jointly fund Medicaid<\/span>, each state determines its own eligibility requirements and<\/span> preferred drug list<\/span><\/a> (<\/span>PDL<\/span>). So while <\/span>Medicaid<\/span> might cover <\/span>Linzess<\/span> most of the time, whether you qualify for <\/span>Medicaid<\/span> depends on your state. And Linzess may or may not be on the PDL in your state.<\/span><\/p>\n

Typically, the eligibility requirements include an<\/span> income limit<\/span><\/a>\u2014you must only make up to a certain percentage of the federal poverty level\u2014but this limit varies by state. To see if you\u2019re eligible, you\u2019ll need to<\/span> contact your state\u2019s <\/span>Medicaid<\/span> agency<\/span><\/a>. Some states even allow you to check your eligibility by answering some questions online.<\/span><\/p>\n

To see whether your state\u2019s <\/span>Medicaid<\/span> plan specifically covers <\/span>Linzess<\/span>, you\u2019ll want to check its <\/span>PDL<\/span>. You should be able to find this document on the state government\u2019s <\/span>Medicaid<\/span> website. Typically, these lists label prescription drugs as \u201cpreferred\u201d or \u201cnon-preferred,\u201d though some might organize them into tiers with different coverage for each. If <\/span>Linzess<\/span> is non-preferred or a higher tier in your state, that doesn\u2019t mean it\u2019s never covered. However, you might need to complete some <\/span>prior authorization<\/span> requirements first, and you might still have an out-of-pocket cost.<\/span><\/p>\n

Most states allow you to do all of this directly on their <\/span>Medicaid<\/span> website, but you can also always call or email the state\u2019s health and human services department if you\u2019d like to ask a representative.<\/span><\/p>\n

Factors influencing <\/span>Medicaid<\/span> coverage for <\/span>Linzess<\/span><\/h2>\n

Even if your state\u2019s <\/span>Medicaid<\/span> plan covers <\/span>Linzess<\/span>, it\u2019s not always as simple as going to the pharmacy and claiming your discount. Some state <\/span>Medicaid<\/span> plans might put restrictions on certain prescription drugs or have extra requirements to meet before you can receive coverage.<\/span><\/p>\n

According to <\/span>Dr. Eve Elizabeth Pennie, MD<\/span><\/a>, an epidemiologist and contributor at<\/span> Drugwatch.com<\/span><\/a>, coverage often depends on<\/span> prior authorization<\/span><\/a>, which insurance plans use to determine whether a drug or treatment is medically necessary. \u201cDocumentation showing failure of first-line treatments such as fiber or laxatives,\u201d she says. \u201cApproval is more likely when the diagnosis and treatment history are clearly documented.\u201d<\/span><\/p>\n

Some plans might also put<\/span> quantity limits<\/span><\/a> on certain drugs. This may limit the length of the prescription a healthcare <\/span>provider<\/span> can write (15 days, 30 days, etc.) or the number of refills allowed. The purpose behind quantity limits is to ensure safe and responsible use, particularly for drugs with a risk of misuse and abuse.<\/span><\/p>\n

How to get <\/span>Linzess<\/span> with <\/span>Medicaid<\/span><\/h2>\n

Dr. Pennie says she and other clinicians \u201ctypically advise patients to coordinate closely with their <\/span>provider<\/span> and pharmacy, ensure accurate coding, and explore assistance programs if coverage is delayed or denied.\u201d This will improve your chances of receiving coverage and establish a backup plan if you\u2019re denied.<\/span><\/p>\n

But if you receive coverage, using it is fairly simple. When you enroll in <\/span>Medicaid<\/span>, you should receive an enrollment card, which contains your personal information and instructions for beneficiaries and <\/span>providers<\/span>. It may also include information about your specific <\/span>Medicaid<\/span> plan, depending on the state. If you don\u2019t receive this card after enrolling, you\u2019ll need to contact<\/span> your state\u2019s <\/span>Medicaid<\/span> or CHIP agency<\/span><\/a> to request one.<\/span><\/p>\n

Before you put that card to good use, however, you\u2019ll need to get a valid <\/span>Linzess<\/span> prescription from your healthcare <\/span>provider<\/span>. If your <\/span>Medicaid<\/span> plan has <\/span>prior authorization<\/span> requirements, you\u2019ll need to comply with those as well. But once you\u2019ve confirmed that <\/span>Medicaid<\/span> will cover your prescription, using your benefits is pretty simple: Just present your enrollment card when you pick up your <\/span>Linzess<\/span> at the pharmacy.<\/span><\/p>\n

Cost of <\/span>Linzess<\/span> with <\/span>Medicaid<\/span><\/h2>\n

According to the <\/span>Linzess<\/span> website, for <\/span>Medicaid<\/span> beneficiaries, \u201cabout 100% of <\/span>Linzess<\/span> prescriptions have an out-of-pocket cost between $0\u2013$10 per month depending on state plan.\u201d Considering that <\/span>Linzess<\/span> can cost several hundred dollars without insurance or other assistance, those are significant savings.<\/span><\/p>\n

This is a generalization, though, and the actual price of your <\/span>Linzess<\/span> prescription depends on your state, your <\/span>Medicaid<\/span> plan, the pharmacy, and the reason you’re taking it.<\/span><\/p>\n

Ways to get discounts on <\/span>Linzess<\/span> without <\/span>Medicaid<\/span><\/h2>\n

Medicaid<\/span> is a reliable way to knock hundreds off the price of your <\/span>Linzess<\/span> prescription\u2014but it\u2019s not the only way. You can also get discounts with a<\/span> SingleCare <\/span>coupon card<\/span><\/a>. It\u2019s completely free to sign up, and instead of paying around $718 for your <\/span>Linzess<\/span> prescription, you might pay as little as $252 for 30, 145mcg capsules at certain Kroger pharmacies.<\/span><\/p>\n

SingleCare partners with more than 35,000 pharmacies nationwide for discounts on over 10,000 drugs, including <\/span>Linzess<\/span>. All you have to do is present your coupon card at one of these pharmacies, and you\u2019ll get your discount.<\/span><\/p>\n

Linzess<\/span>\u2019 manufacturer also offers a savings card that allows eligible patients to pay as little as $30 per month for their prescription. However, not everyone is eligible. Anyone enrolled in Medicare, <\/span>Medicaid<\/span>, TRICARE, VA benefits, or other government assistance programs cannot get this card, and it has an annual maximum benefit of $2,280.<\/span><\/p>\n

Private insurance plans or nonprofit assistance, such as the Patient Advocate Foundation\u2019s Co-Pay Relief Program, are options as well and can provide significant savings.<\/span><\/p>\n

The SingleCare prices in this article are the most accurate at the time of publishing in ZIP code 23666 as of 02\/25\/26. Prices vary by pharmacy. Visit our <\/span><\/i>Linzess<\/span><\/i> coupon page for updated <\/span><\/i>Linzess<\/span><\/i> prices near you.<\/span><\/i><\/small><\/p>\n","protected":false},"excerpt":{"rendered":"

Just ask the 25-45 million US adults who have irritable bowel syndrome or the approximately 35 million who have chronic idiopathic constipation (CIC): It can make life a challenge. Fortunately, Linzess (linaclotide) can help, treating the abdominal pain, bloating, and constipation associated with IBS-C or CIC\u2014but those benefits cost money. The specific cost you might […]<\/p>\n","protected":false},"author":15,"featured_media":635730,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[4589],"tags":[20956,16],"coauthors":[8861],"class_list":["post-635729","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-drug-info","tag-ibs","tag-medicaid","wpautop"],"acf":[],"yoast_head":"\nIs Linzess covered by Medicaid?<\/title>\n<meta name=\"description\" content=\"Find out if Medicaid covers Linzess and what you might pay. 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