Medical Formula Questions and Answers

Medical Formula Questions & Answers

Information for Health Care Providers

Minnesota WIC Program

What are MN WIC Medical Formulas?

The following are considered "Medical Formulas" in WIC:

  • WIC-allowed Exempt Infant Formulas and Medical Formula
  • MN WIC Contract standard formulas for children ≥1 year

Back to Top

What Medical Formulas does MN WIC provide?

Medical Formulas (Exempt Formula, Medical Foods) that May Be Provided by WIC (PDF: 14.41KB/1 page)

Back to Top

Who can receive Medical Formula?

Infants, children and women enrolled in the WIC program who have documented medical needs.

Back to Top

Who can prescribe Medical Formula?

WIC will accept prescriptions from the following:

  • MD
  • Physician's Assistant supervised by a medical physician
  • Certified Nurse-Midwife
  • Nurse Practitioner (Certified Clinical Nurse Specialist) who has an agreement with a physician based on standards established by the Minnesota Nurses Association and the Minnesota Medical Association
  • Licensed doctor of osteopathy duly licensed to practice medicine

Back to Top

What documentation is required for Medical Formulas?

Medical Formula Documentation Form
(PDF: 208KB/1 page)


Prescription with all the following information:

  • Qualifying medical condition/medical diagnosis
  • Name of formula and/or supplemental foods
  • Prescribed amount(s) per day
  • Length of time required
  • Health Care Provider signature, date and contact information

Back to Top

What are the qualifying and non-qualifying medical conditions for Medical Formulas?

Qualifying and Non-Qualifying Conditions for Medical Formulas
PDF: 46.77KB/1 page)

NOTE: All prescriptions are subject to WIC approval based on WIC federal regulations and policies.

Back to Top

How often is a new prescription for Medical Formula needed?

Every 6 months or any time the prescription changes.

Back to Top

Besides Medical Formula, can WIC participants also receive other WIC foods?

Yes, with medical documentation, WIC participants ≥6 months may receive all WIC supplemental foods they would otherwise be eligible to receive.

Back to Top

Where and how can WIC approved Medical Formulas be purchased?

Depending on the product, these may be purchased at WIC-approved pharmacies or grocery stores. Families or WIC staff should call ahead to make sure the product is available. WIC staff can also order directly through the state WIC office. It may be necessary for the health care provider to make temporary arrangements, such as providing samples or using an alternate product, until the prescribed product arrives.

Back to Top

How much Medical Formula/supplemental foods will WIC provide?

Medical Formula and Supplemental Foods
PDF: 41.52KB/1 page)

NOTE: With medical documentation, infants, whose medical condition prevents them from consuming complementary infant foods, are eligible to receive a quantity of Medical Formula equal to the maximum monthly allowance for infants 4 through 5 months of age.

Back to Top

Are items such as thickening agents provided by WIC?

No. The following items are not provided by WIC per Federal Regulations:

  • Any apparatus or devices (e.g., enteral feeding tubes, bags, pumps) designed to administer WIC formulas
  • Thickening agents
  • Flavor packets
  • Medicines or drugs
  • Parenteral or intravenous nutrition products
  • Enzymes
  • Oral rehydration fluids or electrolyte solutions

Back to Top

What happens when a WIC participant is prescribed a formula or medical food 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. Or the caregiver can pay for the product.

Back to Top