WIC Health Care Providers Frequently Asked Questions
When is a Medical Documentation – Health Care Provider Authorization Form (WIC-27) required?
- 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?
- 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 (6) months.
Note: Some formulas are subject to approval lengths less than 6 months (e.g., metabolic formulas).
How do I submit a WIC-27?
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.
Can a physician use a stamp for their signature?
No, the physician’s signature is required.
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 child over two (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 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.
How much formula can be provided to infants over six (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 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.
Are items such as thickening agents provided by the Missouri WIC program?
- 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
Please use the following letter to notify insurance companies of items not allowed by WIC.
WIC Non-allowable Items Letter.
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.