A translation threshold that includes both a percentage and a numerical threshold, for example, 5 percent of the population in the plan service area or 500 plan members, offers the best consumer protection.
Federal regulations governing Medicare Part C and D plans require the plans translate marketing documents and Part D transition letters into any language spoken by five percent of the population in the plan benefit service area. 42 CFR 422.2264(e), 423.2264(e). Regulations also require that plans provide interpreter services in all languages. 42 CFR 422.111(h)(1), 423.128(d)(1). The current Medicare regulations do not include a numerical threshold. Language access guidance by the Department of Health and Human Services for recipients of HHS funds requires a four step analysis of language needs but sets a safe harbor of five percent or 1000 personswhichever is less, of the population of persons eligible to be served or likely to be affected or encountered.
The draft Medicare Managed Care Manual at 30.7.1 requires that plans include inserts in 15 languages telling members that free interpretation services are available by calling the plan’s toll-free number. The inserts must be part of mailings of the plan summary of benefits and its annual notice of change/Explanation of Coverage. The manual (at 50.4) also requires that, for any documents that must be translated based on the five percent threshold for language translation, the plan must place a notice on the English-language version that states, in English and in any required languages, that the material is available for free in other languages and providing a toll free number to contact.
The Empire Justice Center has collected Federal and New York information on language access requirements and resources in health care programs.
Notices should be available in a variety of formats for individuals with visual impairments. The Social Security Administration offers beneficiaries the option of notices in Braille, on a compact disc, on an audio CD or in large print.