How to Request Translator Services for Medication Counseling

When you’re prescribed a new medication, understanding how to take it isn’t optional-it’s life-or-death. But if English isn’t your first language, getting clear instructions from your pharmacist can feel impossible. You might nod along, afraid to admit you don’t understand, only to later mix up your doses, miss warnings, or take the wrong pill. That’s not your fault. It’s a system failure. And you have the right to fix it.

Why Language Help Isn’t Optional-It’s the Law

Federal law requires pharmacies that accept Medicare, Medicaid, or any federal funding to provide free language assistance during medication counseling. This isn’t a suggestion. It’s enforced by Section 1557 of the Affordable Care Act, updated in 2025. If you’re Limited English Proficient (LEP), you’re entitled to a qualified interpreter-not a family member, not a bilingual cashier, not a Google Translate screen.

The stakes are high. A 2012 study from UC San Francisco found LEP patients experience medication errors at three times the rate of English speakers when no interpreter is available. In 2022, a national pharmacy chain paid $1.2 million in penalties after HHS found they routinely skipped interpreter services. That’s not an outlier-it’s a pattern.

How to Ask for Help-Without Being Polite

You don’t need to beg. You don’t need to apologize. You just need to say it clearly:

• "I need a professional interpreter for my medication counseling."
• "I don’t understand English well. Please connect me with someone who can explain this in my language."
• "I’m not comfortable using my child/friend as an interpreter. I need a trained professional."

Pharmacists are required to respond immediately. If they say, "We don’t have one right now," ask: "Can you call one now?" Federal law says they must. No delays. No excuses. No charges.

Don’t accept phrases like, "I’ll just write it down" or "My cousin speaks Spanish-let me ask him." Written instructions alone aren’t enough. Medication counseling involves questions, follow-ups, and clarifications. You need real-time, two-way communication.

What Types of Interpreter Services Are Available?

There are three main ways pharmacies provide interpreters. Each has pros and cons:

1. Phone Interpreting (Most Common)

Most chain pharmacies like CVS, Walgreens, and Rite Aid use phone-based services like RxTran or Language Line. You’ll be connected to a live interpreter in under 30 seconds. It’s cheap for the pharmacy ($2.50-$3.50 per minute) and available 24/7.

But it’s not perfect. A 2019 study at Massachusetts General Hospital found 32% of older LEP patients got confused during phone calls-especially if they couldn’t see the pharmacist’s gestures or read the label together. If you’re elderly, hard of hearing, or new to the U.S., ask for video instead.

2. Video Remote Interpreting (Best Balance)

Video interpreting lets you see the interpreter’s face and hand movements. This helps with nonverbal cues-like when someone points to a pill bottle or mimics swallowing. It’s becoming the new standard. By 2023, 65% of U.S. healthcare facilities used it, according to CMS.

Cost: $3-$5 per minute. Works best with stable Wi-Fi. If the video freezes, ask to switch to phone. Don’t let tech issues compromise your safety.

3. In-Person Interpreters (Gold Standard)

Nothing beats face-to-face. An interpreter can watch your facial expressions, adjust explanations based on your reactions, and even help you read the label together. Pharmacists report 78% better comprehension with in-person interpreters, according to the National Association of Chain Drug Stores (2022).

But they’re rare. Only urban pharmacies in big cities like Boston, Los Angeles, or Chicago have them on-site. If you’re in a smaller town, ask if they can bring one in. Some states, like California, require pharmacies to schedule on-site interpreters for high-volume LEP populations.

What Languages Are Covered?

By law, pharmacies must provide services in any language a patient speaks. But in practice, availability depends on the provider.

California leads the nation. Since 2013, its SafeRx program has standardized translated medication directions (called SIGs) in five languages: Spanish, Chinese, Korean, Russian, and Vietnamese. These are printed directly on prescription labels.

But even in California, 38% of Russian-speaking patients reported confusion because the translations didn’t match how medical terms are structured in Russian. That’s why trained interpreters are still needed-even with printed materials.

New languages are coming. In 2024, California began piloting translations for Tagalog and Arabic. Nationally, the top 10 languages requested in pharmacies are Spanish, Chinese, Vietnamese, Arabic, Russian, Korean, French, Haitian Creole, Portuguese, and Urdu.

What to Avoid-And Why

Never let a family member, friend, or untrained staff member interpret your medication instructions. Here’s why:

• Family members may soften warnings to avoid scaring you. "Don’t drink alcohol" becomes "maybe don’t drink too much."
• They might not know medical terms like "hypotension," "anticoagulant," or "take on an empty stomach."
• A 2021 JAMA Pediatrics study found using untrained interpreters increases serious medication errors by 49%.
• Even bilingual pharmacy staff aren’t automatically qualified. Only 12% of self-declared bilingual employees pass medical terminology tests, according to a 2022 University of Arizona study.

Don’t be shy to say: "I need a certified medical interpreter. This is a federal requirement."

What Happens If They Refuse?

If a pharmacy refuses to provide an interpreter, document everything:

• Write down the date, time, and name of the pharmacist.
• Record what was said-verbatim if possible.
• Ask for a manager.

If they still refuse, file a complaint with the Office for Civil Rights (OCR) at HHS. Since 2016, enforcement actions have increased by 200%. In 2023 alone, there were 47 settlements involving language access violations in healthcare.

You can also call the National Health Law Program’s hotline at 1-800-451-2410. They help patients navigate these issues for free.

What Pharmacies Should Be Doing (But Often Don’t)

Good pharmacies follow a three-step process:

1. Identify the language need using a simple question: "What language do you prefer for medical information?"
2. Access an interpreter through approved channels: phone, video, or in-person.
3. Document the service using billing code T-1013 and the CPT code for the visit. This is required by CMS since 2009.

They must also record: the language requested, type of service used, duration, and proof the interpreter was qualified. Without this, they can’t get reimbursed by Medicaid.

And here’s the kicker: Medicaid now pays pharmacies 75% of the cost for interpreter services when serving children in non-English-speaking households (updated November 2023). That means pharmacies have a financial incentive to do this right.

What You Can Do Right Now

Don’t wait for the system to fix itself. Here’s your action plan:

1. Before your next refill, call the pharmacy and say: "I speak [language]. I need an interpreter when I pick up my prescription. Can you confirm you’ll have one available?"
2. If you’re picking up in person, bring a printed copy of your medication list in your language (if you have one). It helps the interpreter stay on track.
3. If you’re given a printed SIG (Directions for Use), check if it’s in your language. If not, ask for one. California’s versions are available online at www.pharmacy.ca.gov (even if you’re not in California, you can use them as a reference).
4. If you’re ever unsure, ask: "Can you repeat that? I want to make sure I understand." No one should make you feel bad for asking.

The Bigger Picture

More than 11 million Medicaid beneficiaries are LEP. That’s 14.7% of all enrollees. By 2030, that number will grow to 28.6 million. Pharmacies can’t afford to ignore this anymore.

Right now, only 54% of community pharmacies have formal interpreter request systems. The rest are playing Russian roulette with patient safety.

But you hold the power. Every time you ask for a qualified interpreter, you’re not just protecting yourself-you’re pushing the system to improve. You’re making it harder for pharmacies to cut corners. You’re helping create a standard that saves lives.

Medication counseling isn’t a bonus service. It’s a core part of your care. And you deserve to understand it fully.