WIC Health Care Providers Frequently Asked Questions

A WIC-27 is required for women, infant, and child participants who have a documented qualifying condition that requires 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.

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

Examples of non-qualifying conditions are formula intolerance, spitting up, colic, personal preference, and solely for the purpose of managing body weight.

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

A new WIC-27 must be completed at least every six (6) months.

Note: Some formulas are subject to approval lengths less than 6 months (e.g., metabolic formulas).

A WIC-27 may be faxed, hand-delivered by the WIC participant to the local agency, or completed at the health care provider’s office and sent electronically.

A verbal order by telephone may be approved by an authorized local agency staff member to issue (1) 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.

No, the physician’s signature is required.

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.

Yes. Other WIC food, including milk, may also be provided to an individual participant if medically warranted.

No. There is no provision in the policy allowing children between the ages of 12-23 months of age to receive low-fat milk.

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.

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.

Depending on the product, these may be obtained from authorized WIC pharmacies or retailers. Families or WIC staff should 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.

If authorized by a health care provider on the WIC-27, infants over six (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 four (4) through five (5) months of age.

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

1. 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.
2. 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.
3. 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.