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, getting clear instructions from your pharmacist can feel impossible. You might nod along, afraid to admit you don’t understand. That’s exactly when mistakes happen. Medication counseling translator services exist to fix that gap-and by law, pharmacies must provide them for free.

Why You Need a Professional Interpreter for Medication Counseling

Using a family member, friend, or untrained staff member to interpret medication instructions is risky. A 2021 study in JAMA Pediatrics found that relying on untrained interpreters increases the chance of serious medication errors by 49%. That’s not a small risk. It’s the difference between taking one pill a day and accidentally taking four.

Pharmacists are trained to explain things like: when to take the pill, what to avoid eating with it, side effects to watch for, and what to do if you miss a dose. But if those instructions get lost in translation-even slightly-you could end up in the ER. The University of California San Francisco found that Limited English Proficiency (LEP) patients experience medication errors at three times the rate of English speakers when no professional interpreter is used.

Federal law doesn’t just recommend professional interpreters-it requires them. Section 1557 of the Affordable Care Act (2010) says any pharmacy or clinic that gets federal funding must provide language assistance at no cost to the patient. That includes pharmacies that accept Medicare, Medicaid, or any other government health program. You’re not asking for a favor. You’re exercising a legal right.

How to Ask for a Translator-The Right Way

Don’t wait until the pharmacist starts reading the label. As soon as you walk up to the counter, say clearly: “I need a professional interpreter for my medication counseling.” Don’t say, “Can someone help me?” or “My daughter speaks English.” Those phrases leave room for refusal.

Pharmacies are required to respond immediately. If they say they don’t have an interpreter on hand, ask for one of these three options:

• Phone interpreting (they’ll dial a service like RxTran or LanguageLine)
• Video interpreting (a screen will show a live interpreter)
• On-site interpreter (available in larger pharmacies, especially in cities)

They cannot charge you. They cannot make you wait hours. And they cannot use a staff member who hasn’t been certified in medical terminology. If they push back, ask to speak to the manager. If they still refuse, file a complaint with the U.S. Department of Health and Human Services (HHS) Office for Civil Rights. Since 2016, they’ve settled 47 cases involving pharmacies that failed to provide language services-including a $1.2 million penalty against a national chain in 2022.

What to Expect During the Session

A good interpreter won’t just translate words-they’ll make sure you understand context. For example, if the label says “take with food,” the interpreter will explain what counts as food (a banana? a cup of coffee?). If the warning says “may cause dizziness,” they’ll tell you whether that means you shouldn’t drive, stand up quickly, or use machinery.

The session should include:

• Why you’re taking this medication
• Exact dosage and timing
• What to do if you miss a dose
• Side effects and when to call your doctor
• Drug interactions (with food, alcohol, or other meds)
• Storage instructions

The pharmacist should also give you a printed copy of the instructions in your language. In California, the Board of Pharmacy requires pharmacies to have pre-translated directions (called SIGs) in Spanish, Chinese, Korean, Russian, and Vietnamese. These are available on their website and printed directly on prescription labels. Other states are catching up-but not all have the same standards.

Types of Interpreter Services Compared

Not all interpreter services are created equal. Here’s how the main options stack up:

Most chain pharmacies use phone or video services. On-site interpreters are rare outside big hospitals or major cities. But video interpreting is growing fast-65% of healthcare facilities now use it, according to CMS data from 2023. It’s the best balance of cost, speed, and clarity.

What Makes an Interpreter Qualified?

Not every bilingual person is qualified to interpret medical instructions. The American Translators Association requires certified medical interpreters to:

• Complete at least 40 hours of specialized training
• Pass a national certification exam
• Undergo continuing education every two years

A 2022 University of Arizona study found that only 12% of pharmacy staff who call themselves “bilingual” actually meet these standards. Many can translate casual conversation but don’t know terms like “hypertension,” “adverse reaction,” or “therapeutic index.”

Ask your pharmacy: “Is your interpreter certified in medical terminology?” If they hesitate or say “we use whoever’s available,” that’s a red flag. You have the right to request a certified professional.

What’s New in 2025

As of January 1, 2025, federal rules now ban the use of AI tools like Google Translate or ChatGPT for printing instructions on prescription labels or patient handouts-even if they seem accurate. Human review is mandatory. This change came after several cases where AI mistranslated “take with food” as “take after meals only,” leading patients to skip doses.

Also in 2025, the Centers for Medicare & Medicaid Services (CMS) increased reimbursement for interpreter services for children in low-income families-from 50% to 75% federal matching. That means more pharmacies will invest in better services because they can get paid back more.

California is expanding its translated SIGs to include Tagalog and Arabic, with pilot programs rolling out in Los Angeles County. That’s important because 22% of LEP patients there speak languages not covered by the current five translations.

What to Do If You’re Refused Service

If a pharmacy refuses to provide an interpreter:

1. Ask to speak to the manager. State clearly: “I’m requesting a professional interpreter under Section 1557 of the Affordable Care Act.”
2. If they still refuse, take note of the date, time, location, and names of staff involved.
3. File a complaint at HHS.gov/ocr. You can do this anonymously.
4. Call your state’s pharmacy board. In California, it’s the Board of Pharmacy; other states have similar offices.

You don’t need a lawyer. You don’t need to be angry. Just be firm and document everything. HHS has been increasing enforcement-47 settlements since 2016, with more coming.

How Pharmacies Are Supposed to Track This

Pharmacists are required to document every interpreter request using a billing code: T-1013. This code is used alongside the regular medical visit code. It’s how pharmacies get reimbursed for interpreter services.

Documentation must include:

• The language requested
• How the interpreter was provided (phone, video, in-person)
• Duration of the session
• Confirmation that the interpreter was qualified

If you’re a patient, you don’t need to track this. But if you’re ever asked to sign a form saying “no interpreter needed,” don’t sign it unless you truly understand everything. If you’re unsure, say: “I need an interpreter to confirm.”

Final Tip: Know Your Rights Before You Go

Before picking up your prescription, prepare. Know your language. Know your rights. And don’t be afraid to speak up.

You’re not being difficult. You’re being smart. Medication errors are one of the leading causes of preventable hospital visits. And for LEP patients, language barriers are the biggest factor.

The system is designed to protect you. Use it. Demand it. If you don’t, someone else might pay the price.