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Medical Formula Questions & Answers

MN WIC Program

What are MN WIC Medical Formulas?

The following are considered "Medical Formulas" in WIC:

small red bullet  WIC-allowed Exempt Infant Formulas and Medical Formula

small red bullet  MN WIC COntract standard formulas for children ≥1 year

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What Medical Formulas does MN WIC provide?

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

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Who can receive Medical Formula?

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

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Who can prescribe Medical Formula?

WIC will accept prescriptions from the following:

small red bullet  MD

small red bullet  Physician's Assistant supervised by a medical physician

small red bullet  Certified Nurse-Midwife

small red bullet  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

small red bullet  Licensed doctor of osteopathy duly licensed to practice medicine

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What documentation is required for Medical Formulas?

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

OR

red bullet  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

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

Apple Bullet  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.

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How often is a new prescription for Medical Formula needed?

At every WIC certification or any time the prescription changes.

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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.

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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.

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How much Medical Formula/supplemental foods will WIC provide?

Apple Bullet  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.

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Are items such as thickening agents provided by WIC?

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

small red bullet  Any apparatus or devices (e.g., enteral feeding tubes, bags, pumps) designed to administer WIC formulas

small red bullet  Thickening agents

small red bullet  Flavor packets

small red bullet  Medicines or drugs

small red bullet  Parenteral or intravenous nutrition products

small red bullet  Enzymes

small red bullet  Oral rehydration fluids or electrolyte solutions

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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.

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