WIC Health Care Providers Frequently Asked Questions
When is medical documentation required?
- Any participant receiving a medical formula (exempt infant formula or WIC-eligible nutritional)
- Any child (over 12 months of age) 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
What qualifying conditions are allowed by WIC to issue exempt formulas and WIC-eligible nutritionals?
Examples of acceptable qualifying conditions are prematurity, low birth weight, inborn errors of metabolism, gastrointestinal disorders, malabsorption syndromes, immune system disorders, severe food allergies requiring an elemental formula, diagnosed food allergy or formula intolerance to lactose, life threatening disorders, and diseases and medical conditions that impair ingestion, digestion, absorption, or the utilization of nutrients that could adversely affect the participant’s nutrition status.
What qualifying conditions are not allowed by WIC when requesting exempt formulas and WIC-eligible nutritionals?
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 a Medical Documentation Health Care Provider Authorization Form (WIC-27)?
- Medical doctor (MD)
- 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
- Licensed doctor of osteopathy duly licensed to practice medicine. The Medical Documentation Health Care Provider Authorization Form (WIC-27) is used when prescribing exempt formula or WIC-eligible nutritionals (medical food) for WIC participants. To access the Medical documentation form, click here.
What is the approval length for medical documentation?
A Medical Documentation Form (WIC-27) must be completed at least every six (6) months.
What if the agency receives a Medical Documentation Health Care Provider Authorization Form (WIC-27) from the health care provider and some clarifications are needed before issuing the food benefits?
The WIC local agency must follow up with the physician by telephone and clarify the missing information on the WIC-27. If the physician does not call back in a reasonable timeframe the WIC local agency may issue one (1) month of food benefits based on information provided on the WIC-27. However, a complete WIC-27 must be received before additional formula and food is issued.
Can a physician use a stamp for their signature?
No, the physician’s signature is required.
Is the height, weight, and hemoglobin required on the Medical Documentation Health Care Provider Authorization Form (WIC-27)?
No, these fields were added in the event health care providers would like to provide referral information.
What if the physician did not complete section C for the “WIC Supplemental Food” on the Medical Documentation Form (WIC-27)?
The WIC local agency must follow up with the physician by telephone to clarify the missing information before WIC supplemental food can be issued.
Can the WIC local agency complete section C “WIC Supplemental Food” on the Medical Documentation Form (WIC-27) prior to faxing or the participant taking the form to the doctor’s office?
Yes, the designated professional at the WIC office is allowed to complete the supplemental food section based on the participant’s nutritional needs.
Can participants receive both milk and formula?
Yes. Other WIC food, including milk, may also be provided to an individual participant if medically warranted and with medical documentation.
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 formula or WIC-eligible nutritional?
With medical documentation the child or woman may receive combinations of exempt formulas or WIC-eligible nutritionals up to 455 fl oz liquid concentrate 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 or WIC-eligible nutritionals obtained to meet participant needs?
Depending on the product, these may be obtained from WIC approved pharmacies or retailers. (Retailers/LA locations) 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?
With medical documentation, 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 4 - 5 months of age.
Are items such as thickening agents provided by the Missouri WIC program?
- Any apparatus or devices (e.g., enteral feeding tubes, bags, pumps) designed to administer formulas
- Thickening agents
- Flavor packets
- Medicines or drugs
- Parenteral or intravenous nutrition products
- Oral rehydration fluids or electrolyte solutions
What happens when a WIC participant is prescribed a formula or a WIC-eligible nutritional not allowed by WIC, or an amount that exceeds the maximum quantities WIC may provide?
The health care provider can initiate the process to determine if the product will be covered by medical assistance or private insurance. The caregiver may be required to pay for the product to meet the participant’s needs.