How to Request Translator Services for Medication Counseling

When you or a loved one is prescribed a new medication, 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. Without a qualified interpreter, even simple instructions like "take one tablet twice daily" can become confusing, dangerous, or even deadly. The good news? You have a legal right to a professional interpreter during medication counseling-and pharmacies are required by law to provide it, free of charge.

Why Language Help Isn’t Optional

In 2012, a study from the University of California San Francisco found that patients with limited English proficiency (LEP) were three times more likely to make serious medication errors than English-speaking patients. These aren’t small mistakes. They’re missed doses, wrong amounts, dangerous drug interactions-all because the patient didn’t fully understand what they were being told.

Federal law backs this up. Section 1557 of the Affordable Care Act, updated in 2025, says any pharmacy or clinic that takes federal funds (which includes most Medicaid and Medicare providers) must offer free language assistance. That means interpreters, translated materials, or both. And it’s not just a suggestion-it’s enforced. Since 2016, the U.S. Department of Health and Human Services has settled 47 cases against healthcare providers for failing to provide language services. One national pharmacy chain paid $1.2 million in 2022 for not giving LEP patients proper counseling.

What Counts as a Qualified Interpreter?

Not every bilingual person is qualified to interpret medication instructions. A friend who speaks Spanish? A cousin who works at the pharmacy? A staff member who says they know some French? These aren’t enough.

Professional interpreters must:

• Have formal training in medical terminology (at least 40 hours, according to the American Translators Association)
• Pass certification exams in both English and the patient’s language
• Understand how to translate dosage instructions, side effects, and warnings accurately
• Follow strict confidentiality rules

A 2021 study in JAMA Pediatrics showed that using family members or untrained staff as interpreters increases the risk of serious medication errors by 49%. That’s not a small risk. That’s a medical safety failure.

How to Ask for Help-The Right Way

You don’t have to wait for the pharmacist to offer help. If you need an interpreter, say it clearly:

"I need a professional interpreter for my medication counseling. I don’t understand English well enough to safely take this medicine."

Don’t say: "Can you just explain it in Spanish?" or "My daughter can help." That opens the door for unqualified help. You have the right to a trained, certified interpreter.

Pharmacies must respond immediately. In California, the law is even clearer: if a pharmacist can’t communicate clearly with you, they must use an interpreter-either in person or over the phone-before giving you your prescription. And you don’t pay a cent.

Three Ways Pharmacies Provide Interpreters

There are three main ways pharmacies connect you with an interpreter. Each has pros and cons:

1. Phone Interpreting (Most Common)

Services like RxTran or Language Line connect you via phone in under 30 seconds, 92% of the time, according to pharmacy logs. It’s cheap-around $2.50 per minute-and available 24/7.

But it’s not perfect. A 2019 study at Massachusetts General Hospital found that 32% of elderly LEP patients got confused during phone calls. Without seeing the pharmacist’s face or gestures, it’s harder to pick up on tone or urgency.

2. Video Remote Interpreting (Best Balance)

This is growing fast. By 2023, 65% of healthcare facilities used video interpreting. You see the interpreter on a tablet or screen. You can see their facial expressions, hand gestures, and even read lips if needed.

Cost: $3-$5 per minute. Better than phone. Less expensive than in-person. Works well for complex discussions like checking side effects or explaining a new insulin regimen.

3. In-Person Interpreters (Gold Standard)

Nothing beats face-to-face. The pharmacist can point to a pill bottle, show a dosing cup, or demonstrate how to use an inhaler while the interpreter translates. This is especially important for older adults, people with low literacy, or those taking multiple medications.

But it’s not always possible. In-person interpreters are expensive ($45-$75/hour) and mostly available in big cities. Smaller rural pharmacies often rely on phone or video.

What’s Already Translated? Know Your Rights

Many pharmacies use pre-translated materials for common medications. California’s SafeRx program, for example, has official, government-approved translations of prescription directions (called SIGs) in five languages: Spanish, Chinese, Korean, Russian, and Vietnamese. These are printed right on the label.

But here’s the catch: translations aren’t perfect. A 2022 survey by California’s Department of Consumer Affairs found that 38% of Russian-speaking patients said the dosage instructions were confusing because the grammar didn’t match how medical terms are used in Russian.

That’s why you should never assume the label is enough. Always ask for live counseling-even if the label is in your language.

What to Do If the Pharmacy Refuses

If a pharmacist says, "We don’t have an interpreter right now," or "We can’t afford one," they’re breaking the law.

Here’s what to do:

1. Ask to speak with the pharmacy manager.
2. State clearly: "I am legally entitled to a professional interpreter under federal law. I will not take this medication until I understand it fully with a qualified interpreter."
3. If they still refuse, file a complaint with the Office for Civil Rights (OCR) at HHS.gov. You can do it online in minutes.

You can also call the National Health Law Program’s hotline for free legal advice. They help patients like you every day.

What Pharmacists Must Do

Pharmacists aren’t just handing out pills. They’re responsible for making sure you understand your meds. Here’s what they’re supposed to do:

1. Ask every patient: "What language do you prefer to speak?" (This is now standard practice in most chain pharmacies.)
2. Use only approved interpreter services: phone, video, or in-person. No family, no untrained staff.
3. Document everything: language requested, type of service used, duration, and interpreter’s name or ID number.
4. Use the correct billing code: T-1013 for language services, paired with the medical visit code.

Training for pharmacy staff takes only 2-4 hours. But many don’t get it. A 2023 audit found that only 41% of staff who claimed to be "bilingual" could correctly translate basic medical terms like "side effect" or "take on an empty stomach."

What’s Changing in 2025?

New rules took effect on January 1, 2025:

• AI translation tools (like Google Translate) are now banned for use on prescription labels and medication counseling materials unless a human reviews them first.
• Medicaid now reimburses pharmacies 75% of interpreter costs for children in non-English-speaking households (up from 50%).
• California is adding translations for Tagalog and Arabic, after identifying those as the fastest-growing languages among LEP pharmacy patients.

These changes show one thing: the system is getting better-but only if people demand it.

Real Stories, Real Risks

One Reddit user, a pharmacist with 12 years of experience, wrote: "We use RxTran’s phone service daily. But our Mandarin interpreters often don’t know the word for 'sustained-release.' So they just say 'slow pill.' Patients think they can crush it. That’s dangerous." Another patient, a Vietnamese grandmother in Los Angeles, said: "The label said 'take one in the morning.' I thought that meant once a day. The interpreter told me it was twice. I didn’t know I was supposed to ask." These aren’t rare cases. They’re systemic failures.

Your Next Steps

1. Always ask for a professional interpreter before taking any new medication.

2. Don’t accept family members, friends, or untrained staff as interpreters-even if they seem fluent.

3. Write down your questions before your appointment: "What does this do?" "What happens if I miss a dose?" "What foods or drugs should I avoid?" 4. Request a printed copy of the translated instructions in your language.

5. Report refusal to HHS’s Office for Civil Rights. Your voice protects others.

You don’t need to be fluent in English to get safe, accurate care. You just need to know your rights-and use them.