Linzess (Linaclotide) Medicare Coverage

Linzess
Chemical name: Linaclotide Brand name: Linzess Typical dosage: 145mcg Typical type: Capsule¹ Linzess is a medication used for chronic constipation and for treatment of irritable bowel syndrome. Linzess is available as brand-name only and comes as an oral capsule.

Linzess is used to treat general constipation and to treat constipation related to irritable bowel syndrome. It works in the intestine to increase fluid and movement within the bowels.

Linzess is a medication that contains the active ingredient Linaclotide. It is typically taken once daily. Linzess is typically well tolerated, but can lead to stomach pain, diarrhea and signs of a common cold.

Does Medicare cover Linzess or Linaclotide?

Some Medicare Advantage plans and Medicare Part D plans in your area may cover Linzess.

Medicare Advantage plans that offer prescription drug coverage are called Medicare Advantage Prescription Drug Plans (MA-PD). Most Medicare Advantage beneficiaries (88 percent) are enrolled in MA-PDs.¹
Medicare prescription drugs plans each have their own formulary, or drug list, that details what prescription drugs are covered by the plan and how they are covered.

Drug coverage may vary based on plan availability. You may be able to find Medicare Advantage plan options in your area that cover Linzess.

Find Medicare Advantage plans with drug coverage

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Or call 1-800-557-6059 1-800-557-6059 TTY Users: 711 24/7 to speak with a licensed insurance agent.

You can also compare Part D prescription drug plans available where you live and enroll in a Medicare prescription drug plan online when you visit MyRxPlans.com.

Average costs for Linzess with Medicare drug coverage

Your copay and deductible costs for any prescription drug can vary depending on what coverage stage you’re in and the Medicare drug plan you have.

Deductible stage	Typical copay stage
Your deductible is the amount of money you must spend on covered drugs before your Medicare drug coverage starts paying its share of costs. In the deductible stage, you’re responsible for the full cost of your prescription drugs. Some Medicare prescription drug plans have a $0 deductible. Medicare drug plans cannot have a deductible more than $415 in 2019.	After you meet your Part D deductible, you enter the initial coverage period. During this phase (the typical copay stage), you pay a copayment (flat fee) or coinsurance (percentage) for your covered medications.

Additional information

Take Linzess on an empty stomach at least 30 minutes before the first meal of the day. Do not chew or break the capsule.

If you have trouble swallowing, you can mix the contents of the capsule with applesauce or water. Use the mixture right away and do not chew it.

Linzess should not be used in patients under 18 years of age. Linzess can cause severe dehydration in children that can lead to death.

Let your doctor know if diarrhea becomes severe or if it leads to hospitalization. Signs of significant dehydration due to diarrhea include dizziness, passing out, inability to urinate or extreme fatigue.

This article is for informational purposes only. It is not healthcare advice, treatment, or diagnosis. It is not an endorsement of or recommendation for this medication. Speak to your doctor or healthcare provider about your specific healthcare needs, including your prescription medications. Only take medication as directed by your doctor.

Coverage and costs of prescription medications will vary by Medicare plan. Not all plans are available in all areas.

Written by Hayden Gharibyar, Pharm.D.