How to Request Translator Services for Medication Counseling

When you or a loved one gets a new prescription, understanding how to take it isn’t just helpful-it’s life-saving. But if English isn’t your first language, that understanding can slip through the cracks. Medication errors among people with limited English proficiency (LEP) happen three times more often than among English speakers, according to a 2012 study from UC San Francisco. The fix isn’t complicated: you have a legal right to a professional interpreter during medication counseling. No one should be left guessing whether to take a pill with food, at night, or in halves.

Know Your Rights Before You Walk In

You don’t need to ask nicely. You don’t need to apologize. Under Section 1557 of the Affordable Care Act, any pharmacy or healthcare provider that receives federal funding must provide free language assistance services-including interpreters-for medication counseling. This rule applies whether you’re at a big chain like CVS or a small local pharmacy. You’re not asking for a favor. You’re exercising a right.

How to Ask for an Interpreter

The key is to be direct. Don’t say, “Can someone help me?” or “Is there someone who speaks [language]?” Say: “I need a professional interpreter for my medication counseling.” That phrase triggers the legal obligation. Pharmacists are trained to respond to this request. If they hesitate, ask to speak to the manager. They are required to provide the service at no cost to you.

What Kind of Interpreter Should You Get?

Not all interpreters are created equal. There are three main ways to get help:

• Phone interpreting - Quick and cheap. Services like RxTran connect you in under 30 seconds most of the time. But if you’re elderly or have hearing issues, phone-only can be confusing. One study found 32% of older LEP patients struggled with phone-only counseling.
• Video interpreting - Best balance of cost and clarity. You can see the interpreter’s facial expressions and gestures, which helps with tone and urgency. About 65% of healthcare facilities use this method now. It’s usually $3-$5 per minute.
• On-site interpreter - The gold standard. Especially for complex meds like blood thinners, insulin, or psychiatric drugs. Pharmacists say patients understand 78% better when an interpreter is in the room. But these are harder to find outside big cities.

Never accept a family member, child, or untrained staff member as your interpreter. A 2021 study in JAMA Pediatrics found using family members increases the risk of serious medication errors by 49%. Even if your cousin speaks both languages, they likely don’t know what “take on an empty stomach” means in medical terms-or how to say “avoid grapefruit juice” in your language.

What If the Pharmacy Doesn’t Have an Interpreter?

If the pharmacy says they don’t have one, ask them to call a service. Most pharmacies have contracts with companies like RxTran, LanguageLine, or CyraCom. These services are available 24/7. If they refuse, tell them you know your rights under federal law. You can also ask for written translated materials. In California, pharmacies must have printed directions in Spanish, Chinese, Korean, Russian, and Vietnamese. These are called SIGs (Directions for Patients), and they’re standardized across the state. Other states are catching up.

What’s Included in Medication Counseling?

A real interpreter doesn’t just translate words. They help explain:

• When and how often to take the medication
• What foods or drinks to avoid
• Possible side effects and what to do if they happen
• What to do if you miss a dose
• Why this medication was prescribed for you

Pharmacists are supposed to cover all of this. With an interpreter, they can. Without one, they often skip the hard parts. That’s why you need to insist.

What About Written Translations?

Written materials matter too. Prescription labels should have clear instructions in your language. The RxTran system lets pharmacies print pre-translated warning labels directly onto your bottle. You should get a printed copy of your medication instructions in your language. If you don’t, ask for it. Many pharmacies have these sheets in their back office but won’t offer them unless you ask.

How to Spot a Qualified Interpreter

A professional medical interpreter has:

• At least 40 hours of training in medical terminology
• Certification from a recognized body like the National Board of Certification for Medical Interpreters
• Knowledge of confidentiality rules under HIPAA and the ACA

Don’t be fooled by staff who say, “I speak Spanish.” A 2022 University of Arizona study found only 12% of self-identified bilingual pharmacy workers passed a basic medical terminology test. That’s why federal rules require trained interpreters-not just bilingual employees.

What to Do If You’re Refused

If a pharmacy refuses to provide an interpreter, document everything: date, time, name of staff, what was said. Then file a complaint. You can report violations to the U.S. Department of Health and Human Services’ Office for Civil Rights (OCR). Since 2016, they’ve settled 47 cases involving language access in healthcare-including a $1.2 million fine against a national pharmacy chain in 2022. Your complaint can help others too.

Special Cases: Children, Elderly, and Rural Areas

If you’re caring for a child, the rules are even stronger. As of November 2023, CMS increased reimbursement for interpreter services for children in Medicaid and CHIP from 50% to 75%. That means pharmacies are more likely to have services ready for kids.

For elderly patients, video interpreting is often better than phone. Visual cues help with memory and comprehension. If your parent has dementia or hearing loss, insist on video or in-person help.

In rural areas, on-site interpreters are rare. But phone and video services still work. If your pharmacy claims they can’t connect, ask for the name of their language service provider. Then call that company directly. Most have customer lines you can reach from anywhere.

What’s Changing in 2025?

New rules took effect January 1, 2025: AI translation tools can no longer be used for prescription labels or medication instructions unless reviewed by a human. That means no more Google Translate printouts. Pharmacies must use certified translations.

California is adding new languages-Tagalog and Arabic-to its standardized SIG system. Other states are watching. The number of LEP patients in the U.S. is expected to hit 28.6 million by 2030. That means more pressure on pharmacies to get this right.

Final Tip: Bring a Notebook

Even with an interpreter, take notes. Write down:

• What the medicine is for
• How many pills to take
• When to take them
• What to avoid
• Who to call if something goes wrong

Ask the interpreter to repeat it back to you. If they can’t, ask for someone else. This isn’t just about understanding-it’s about safety.