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HomeBusiness and Professions CodeDiv. 2Ch. 9Art. 4§ 4079 Pharmacy Price Disclosure

§ 4079 Pharmacy Price Disclosure

Business and Professions Code·California
AI Summary·Official Text·Key Terms·Related Statutes·References
AI SummaryVerified

§ 4079 Pharmacy Price Disclosure

Key Takeaways

  • •Pharmacies must tell you if the regular price of your medicine is cheaper than what you'd pay with insurance.
  • •If you pay the cheaper price, the pharmacy still sends the claim to your insurance like you paid the higher price.
  • •The cheaper price you pay still counts toward your deductible and out-of-pocket limit, just like if you paid the higher price.
  • •If a contract says something different from this law, that part of the contract doesn’t count.

Example

You go to the pharmacy to pick up your asthma inhaler. With your insurance, you usually pay $50, but the pharmacy checks and sees the regular price is only $30.

The pharmacy must tell you that the regular price is cheaper. If you choose to pay the $30, the pharmacy will still send the claim to your insurance as if you paid $50. The $30 you paid will count toward your deductible and out-of-pocket limit just like the $50 would have.

AI-generated — May contain errors. Not legal advice. Always verify source.

Official Source
View on CA.gov

§ 4079 Pharmacy Price Disclosure

(a) A pharmacy shall inform a customer at the point of sale for a covered prescription drug whether the retail price is lower than the applicable cost-sharing amount for the prescription drug, unless the pharmacy automatically charges the customer the lower price. (b) If the customer pays the retail price, the pharmacy shall submit the claim to the health care service plan or health insurer in the same manner as if the customer had purchased the prescription drug by paying the cost-sharing amount when submitted by the network pharmacy. (c) The payment rendered shall constitute the applicable cost sharing and shall apply to the deductible, if any, and also to the maximum out-of-pocket limit in the same manner as if the enrollee had purchased the prescription drug by paying the cost-sharing amount. (d) A contract provision that is inconsistent with this section is void and unenforceable. (e) The provisions of this section are severable. If any provision of this section or its application is held invalid, that invalidity shall not affect other provisions or applications that can be given effect without the invalid provision or application. (f) A violation of this provision shall not be grounds for disciplinary action or a criminal action. (g) This section shall become operative on January 1, 2020. (Repealed (in Sec. 1) and added by Stats. 2019, Ch. 114, Sec. 2. (AB 1803) Effective July 12, 2019. Section operative January 1, 2020, by its own provisions.)

Last verified: January 22, 2026

Key Terms

prescriptioninsurancecontractclaimhealthnetpharmacyapplication

Related Statutes

  • § 4033 Manufacturer Definition Exclusions
  • § 4072 Prescription Transmission Authorization
  • § 4076.5 Prescription Drug Label Standards
  • § 4076.8 Accessible Prescription Label Requirements
  • § 4126.5 Pharmacy Drug Distribution Limits

References

  • Official text at leginfo.legislature.ca.gov
  • California Legislature. Business and Professions Code. Section 4079.
View Official Source