Health Care Providers
Welcome to the Health Care Provider Page!
This site provides information for physicians, nurses, dietitians and other health care providers. Partnerships with health care providers are critical to the success of Missouri WIC. You are a key partner in helping WIC participants make healthy choices.
How can health care providers help patients achieve positive health outcomes?
- Make referrals to WIC routinely.
- Tell your patients that WIC is a health and nutrition program.
- Put a brochure in every new patient packet.
- Mention WIC to everyone.
- Encourage them to call their WIC local agency or call 1-800-TEL-LINK (1-800-835-5465).
- Recommend breastfeeding to prenatal clients.
- Refer patients with breastfeeding problems to WIC for help.
Food package
WIC food packages provide supplemental nutrition for low-income pregnant, breastfeeding and non-breastfeeding postpartum women, as well as infants and children up to age five who are at nutritional risk. These food packages, which include fruit, vegetables and whole grains, along with nutrition education, improve dietary quality and habits.
WIC food packages also promote and support the establishment of successful, long-term breastfeeding. They provide WIC participants with a wider variety of food including fruit, vegetables and whole grains.
The USDA WIC Food Packages-Regulatory Requirements for WIC-eligible Foods provides further information on each allowed food group.
Breastfeeding
Breastfeeding and nutrition education are a major focus for Missouri WIC. The program commits a significant amount of resources to promoting and supporting these goals. Missouri WIC supports breastfeeding as the preferred method for infant feeding. WIC peer counselors are on call to answer participants' questions about breastfeeding. WIC counseling staff can provide information about pumping, latch, positioning, returning to work or school and other breastfeeding topics.
These pages offer more information about breastfeeding:
- Breastfeeding and Health Care.
- Information on medications and breastfeeding is available from the National Library of Medicine and the Infant Risk Center.
- Breastfeeding in WIC.
Formula
WIC provides contract formulas as part of a federally mandated cost containment system agreement. In accordance with federal regulations, WIC-eligible formulas are mainly issued in powder form. Current contract formulas provided by Missouri WIC are:
- Similac Advance.
- Similac Sensitive.
- Similac Total Comfort.
- Similac Soy Isomil.
Missouri WIC also provides non-contract standard infant formula, exempt infant formula and WIC-eligible nutritionals to participants with a qualifying condition. These formulas require completion of a Medical Documentation Form (WIC-27) by a health care provider.
- An exempt formula is intended for use by infants who have inborn errors of metabolism, low birth weight or unusual medical or dietary needs.
- A WIC-eligible nutritional product (medical food) is specifically designed for the dietary management of a disease with unique nutritional requirements that cannot be fulfilled by a regular diet alone. This product is intended for women and children participants.
The MO WIC Approved Formulas and WIC-Eligible Nutritionals lists all formulas currently provided by Missouri WIC.
Medical Documentation Form (WIC-27)
The Medical Documentation Form (WIC-27) is required to prescribe non-contract standard infant formula, exempt infant formula and WIC-eligible nutritionals. A health care provider's prescription is not an allowable substitution. A qualifying condition must be present for approval.
Please view the MO WIC Approved Formulas and WIC-Eligible Nutritionals and then proceed to complete the WIC-27. Contact your WIC local agency if you have specific questions about completing a WIC-27.
The completed WIC-27 should be sent to the WIC local agency by one of the ways listed below.
- Faxed.
- Hand-delivered by the WIC participant.
- Email or other secured electronic method.
A verbal order by telephone may be approved by an authorized WIC local agency staff member to issue one month of benefits; however, the signed and completed WIC-27 must be received by the local agency within 1-2 weeks before additional benefits may be issued.
A physician stamp may not be used in place of a signature.
WIC Referral Form (WIC-61)
To be eligible for WIC services, WIC participants must provide proof of pregnancy (if applicable), height and weight measurements and blood work.
This information is sometimes requested from health care providers in order to encourage referrals to health care services. In many cases, height, weight and hemoglobin screening can also be done at the WIC clinic during certification.
Healthcare providers, social service programs and WIC local agency staff can use the WIC Referral Form to refer WIC participants and patients to needed services.
Frequently asked questions
When is a Medical Documentation Form (WIC-27) required?
A WIC-27 is required for women, infant and child participants who have a documented qualifying condition requiring the use of a WIC formula (infant formula, exempt infant formula, WIC-eligible nutritional or metabolic formula) because the use of conventional foods is precluded, restricted or inadequate to address their special nutritional needs. This includes:
- Any participant receiving a medical formula (exempt infant formula or a WIC-eligible nutritional).
- Any child (12 months of age or older) receiving an infant formula.
- Any child (24-59 months of age) or woman receiving whole milk. Formula must also be prescribed when requesting whole milk along with documentation of a medical condition for these participants.
- Any participant receiving contract infant formula with mixing instructions that are different than the product label.
Note: All prescriptions are subject to WIC approval based on WIC federal regulations and policies.
What are some of the medical conditions that qualify participants for WIC-27 approval?
Participants must have one or more qualifying conditions, as determined by a health care professional licensed to write medical prescriptions under state law.
The qualifying conditions include, but are not limited to:
- Premature birth.
- Low birth weight.
- Inborn errors of metabolism.
- Gastrointestinal disorders.
- Malabsorption syndromes.
- Immune system disorders.
- Diagnosed food allergies.
- Life threatening disorders.
- Diseases and medical conditions that impair ingestion, digestion, absorption or the utilization of nutrients.
What conditions DO NOT qualify and will not be approved if provided on the WIC-27 as a medical reason/diagnosis?
Examples of non-qualifying conditions are formula intolerance, spitting up, colic, personal preference, and solely for the purpose of managing body weight.
Who can complete and sign the WIC-27?
WIC will accept a completed and signed WIC-27 from a health care provider with prescriptive authority; this includes:
- Medical doctor (MD).
- Doctor of Osteopathy (DO).
- Physician assistant supervised by a medical doctor.
- Nurse practitioner (certified clinical nurse specialist) who has an agreement with a physician based on standards established by the Missouri Nurses Association and the Missouri Medical Association.
What is the approval length for a WIC-27?
A new WIC-27 must be completed at least every six months.
Note: Some formulas are subject to approval lengths less than 6 months (e.g., metabolic formulas).
Who can complete section C “WIC Supplemental Food” on the WIC-27 form?
Health care providers shall complete section C if food items must be omitted from the food package.
An authorized local agency staff member can complete section C prior to the health care provider’s signature.
Note: Full provision of age/category-appropriate WIC food will be issued unless otherwise indicated in section C.
Can a woman or child receive both milk and formula?
Yes. Other WIC food, including milk, may also be provided to an individual participant if medically warranted.
Is WIC allowed to provide low-fat milk to a child who is between 12-23 months of age, if medical documentation is provided?
No. There is no provision in the policy allowing children between the ages of 12-23 months of age to receive low-fat milk.
Can a woman or child receive a combination of exempt formulas and/or WIC-eligible nutritionals?
If indicated on the WIC-27, participants may receive combinations of exempt formulas and/or WIC-eligible nutritionals up to 910 fluid ounces per month.
Can a woman or a child over 2 years of age receive whole milk?
Yes, but only if they are also receiving an exempt formula or a WIC-eligible nutritional. Whole milk may not be issued solely to manage body weight, but may be issued to manage a medical condition.
Where are WIC-approved exempt formulas and WIC-eligible nutritionals obtained by participants?
Depending on the product, these may be obtained from authorized WIC pharmacies or retailers. Families or WIC staff may call ahead to make sure the product is available. It may be necessary for the health care provider to make temporary arrangements, such as providing samples or using an alternate product, while arrangements are made to make the product available.
How much formula can be provided to infants over 6 months of age whose medical condition prevents them from consuming complementary infant food?
If authorized by a health care provider on the WIC-27, infants over 6 months of age whose medical condition prevents them from consuming complementary infant food are eligible to receive any infant formula (contract or exempt) at the same maximum monthly allowance as infants 4 through 5 months of age.
Are items such as thickening agents provided by the Missouri WIC program?
No. The following items are not provided by WIC, per federal regulations:
- Formulas used solely for the purpose of enhancing nutrient intake, managing body weight or addressing picky eating or conditions other than a qualifying condition (e.g., vitamin pills, weight control products).
- Medicines or drugs.
- Hyperalimentation feedings (nourishment administered through a vein).
- Enzymes, herbs or botanicals.
- Oral rehydration fluids or electrolyte solutions.
- Flavoring or thickening agents.
- Feeding utensils or devices (e.g., feeding tubes, bags, pumps) designed to administer a WIC-eligible formula.
- Sports or breakfast drinks.
What happens when a WIC-27 is written for a formula NOT approved by WIC, or exceeds the maximum quantities WIC may provide?
- The health care provider can refer to the MO WIC Approved Formulas and WIC-Eligible Nutritionals document to prescribe an alternate WIC-approved formula or supplemental food.
- If unable to find a suitable equivalent, the health care provider can initiate the process to determine if the product will be covered by medical assistance or private insurance.
- If medical assistance or private insurance is unable to cover the formula, the caregiver may purchase the formula or locate another source for the formula that meets the participant’s needs.
WIC and Nutrition Services
Missouri Department of Health and Senior Services
PO Box 570
Jefferson City, MO 65102-0570
Telephone: 573-751-6204 or
(toll-free) 800-392-8209
Fax: 573-526-1470
Email: WICinfo@health.mo.gov