General information, not legal advice

Laws and rules change and depend on your situation. Before acting on anything here that could affect your rights or immigration status, confirm with a qualified attorney or an accredited legal representative.

In plain words

Section 1557 is the part of the Affordable Care Act (the health care reform law passed in 2010) that prohibits discrimination based on language in health programs that receive federal funding. In practice, it means most clinics, hospitals, and health plans must provide a free qualified interpreter so you can speak and understand in your own language.

Good mental health care depends on understanding and being understood. In the United States you have a right to language help, and in most cases it must be free. Knowing this before you call a clinic can change how the whole visit goes.

At a glance
  • Under Section 1557 and Title VI, most federally funded health programs must provide free, qualified interpreters.
  • You should not be charged, told to bring your own, or asked to use a child or family member.
  • When you book, say which language you speak and ask for an interpreter at no cost; confirm again at check-in.
  • If a clinic refuses, you can file a complaint with the HHS Office for Civil Rights.

The right, in plain terms

Most health programs and providers that receive federal money must take reasonable steps to give people with limited English proficiency meaningful access to care. This includes free interpretation when you speak with staff and free translation of important written materials. The rule comes from Section 1557 of the Affordable Care Act and from Title VI of the Civil Rights Act of 1964. The U.S. Department of Health and Human Services Office for Civil Rights, the federal office that enforces these protections, describes them on its Section 1557 summary page and its Limited English Proficiency page.

In practice, this means:

  • You should not be charged for an interpreter. Language help is part of your care, not an extra you pay for.
  • You should not be told to bring your own interpreter.
  • You should not have to rely on a child, a family member, or a friend to interpret. A child may step in only for a moment in a true emergency, while a qualified interpreter is being found.
  • The interpreter should be qualified, meaning trained to interpret accurately in a health setting, and not just any staff member who happens to speak some of your language.
Language help is part of your care

You should not be charged for an interpreter, told to bring your own, or asked to rely on a child, a family member, or a friend. A child may step in only for a moment in a true emergency, while a qualified interpreter is being found.

The updated Section 1557 rule describes what “qualified” means. A qualified interpreter must interpret accurately and impartially, know the specialized words used in health care, and keep your tone and feelings, not only the literal words (American Translators Association, 2024). If the clinic connects an interpreter by video, the picture and sound must be clear and not freeze or blur. If it uses a computer to translate an important document, a qualified person must check that translation. Clinics also must post a notice letting you know that free language help is available (American Translators Association, 2024).

Why a qualified interpreter matters

This is about safety, not only comfort. When a trained interpreter is used, there are fewer interpreting errors, and the errors that do happen are less likely to cause harm. Studies have found that untrained or ad hoc interpreters make more mistakes with clinical consequences (Flores et al., 2012), and that professional interpreters improve the quality of care (Flores, 2005; Karliner et al., 2007). In a mental health visit, where the exact words you use carry meaning, an accurate interpreter protects you. A review focused on mental health care found that people share more about painful experiences and symptoms when a professional interpreter is used than with an untrained helper or none at all (Bauer & Alegría, 2010). Being understood is part of getting better.

How to ask, step by step

When you bookSay your language, ask for an interpreter at no cost
At check-inConfirm again on the day of the visit
During the visitAsk for a different interpreter if it is not working
Ask early, confirm on the day, and speak up if the interpreting is not clear.
  1. When you book, say which language you speak and ask for an interpreter at no cost: “I speak [language]. I need a [language] interpreter at no cost to me for my appointment. Can you arrange that?”
  2. Ask how the interpreter will join. It can be in person, by phone, or by video. You can say which you prefer.
  3. Confirm again at check-in on the day of the visit, because interpreters are sometimes missed in scheduling.
  4. If the interpreting is not working, you can ask for a different interpreter. It is okay to say you cannot understand.
Call and say

"Hello. I would like to make a mental health appointment. I speak [language], and I need a professional interpreter at no cost to me for the visit. Can you arrange one?"

If you are refused

If a clinic will not provide an interpreter, you can ask to speak with a supervisor or the patient relations office, and you can choose a community health center, which is used to working with interpreters. You can find one near you at findahealthcenter.hrsa.gov. You can also file a complaint with the HHS Office for Civil Rights, online at ocrportal.hhs.gov or as explained at hhs.gov/civil-rights/filing-a-complaint; filing is free, and it is usually best to do it within 180 days. A community health worker or navigator can help you do this. Many phone lines already include interpreters; the 988 crisis line, for example, connects callers to interpreters in many languages.

Written papers in your language, and getting help in time

Language help is not only spoken. Under Section 1557, important written materials should be available to you in a language you understand, such as consent forms, notices of your rights, instructions for your care, and the clinic’s privacy notice (HHS). Do not sign a paper you do not understand. You can say, “Please give me this in [language], and have the interpreter read it with me first.” If a clinic used a computer to translate an important document, a qualified person is supposed to check it for accuracy (American Translators Association, 2024).

Help should also come in time. You should not be pushed to the back of the line or made to wait much longer than an English speaker just because you need an interpreter (HHS). If your appointment is starting and no interpreter is there, it is fair to say, “I will wait for the interpreter,” and to remind the staff at check-in that you asked for one.

This can vary by state

Federal law sets the floor. Some states add their own language-access laws or pay providers through Medicaid for interpreter services, which can make interpreters easier to get. It is worth checking what your state offers. Your state Medicaid office can tell you what interpreter services are covered where you live.

Sources

LINC is a research prototype, not a medical or legal service. Translation can be wrong; you have the right to a free, qualified interpreter. For anything high-stakes, do it with a community health worker or someone you trust. In a crisis, call or text 988, or 911 for immediate danger.