Get the free Michigan WIC Program - Medical Documentation for WIC Formula and Authorized WIC Foods
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This form is required to document that a WIC client has a qualifying medical condition necessitating the use of WIC formula, medical food, or alterations to their supplemental food package. It includes
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How to fill out michigan wic program
How to fill out Michigan WIC Program - Medical Documentation for WIC Formula and Authorized WIC Foods
01
Obtain the Michigan WIC Program Medical Documentation form from your local WIC office or website.
02
Fill out the participant's personal information, including name, date of birth, and WIC ID number.
03
Indicate the specific medical condition or dietary need that requires WIC formula or authorized foods.
04
Consult with a healthcare provider to complete the medical professional's section of the form, ensuring they sign and date it.
05
Review the completed form for any errors, ensuring all required information is included.
06
Submit the completed Medical Documentation form to your local WIC office as part of the application or recertification process.
07
Keep a copy of the submitted form for your records.
Who needs Michigan WIC Program - Medical Documentation for WIC Formula and Authorized WIC Foods?
01
Pregnant women
02
Breastfeeding mothers
03
Infants
04
Children under the age of five with specific medical conditions or dietary needs
05
Individuals requiring specialized formula or food due to medical conditions
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People Also Ask about
How many cans of formula can I get with WIC?
maximum monthly allowance (MMA): 14 containers of liquid concentrate infant formula x 26 reconstituted fluid ounces = 364 fl. oz.
How much do you get for WIC in Michigan?
Each month, more than 200,000 moms, babies and children less than 5 years of age receive nutritious foods from the Michigan WIC Program. WIC foods are worth between $30-$112 or more per participant each month. One out of every two babies born in Michigan receive WIC benefits.
Why does WIC only give Enfamil?
Pregnant and postpartum women and children (under 5 years of age) participating in WIC receive food benefits for milk, cheese, eggs, cereals, peanut butter, dry beans/peas or canned beans/peas, and fruit or vegetable juices, fresh fruits and vegetables and whole grain choices to include breads, tortillas, brown rice
What formula is approved by WIC in Michigan?
WIC will usually cover specialty formulas as long as they are under the brand umbrella for whatever brand the state contracts with. If your state covers Similac and Enfamil, they should cover Alimentum or Nutramigen with a prescription from the doc.
What formula does Mi WIC authorized?
Standard infant formulas available from the Michigan WIC program are: Similac Advance, Similac Sensitive, Similac Soy Isomil, and Similac Total Comfort. Infants with a specific medical diagnosis and documentation may receive a special formula prescribed by their doctor.
What does WIC authorized mean?
The Special Supplemental Nutrition Program for Women, Infants, and Children - better known as the WIC program - serves to safeguard the health of low-income pregnant, postpartum, and breastfeeding women, infants, and children up to age 5 who are at nutritional risk by providing nutritious foods to supplement diets,
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What is Michigan WIC Program - Medical Documentation for WIC Formula and Authorized WIC Foods?
The Michigan WIC Program provides medical documentation to support the need for specialized WIC formula and authorized food items for participants who have specific dietary requirements due to health conditions.
Who is required to file Michigan WIC Program - Medical Documentation for WIC Formula and Authorized WIC Foods?
Healthcare providers must file the medical documentation on behalf of WIC participants who require specific formulas and authorized foods for dietary or health-related reasons.
How to fill out Michigan WIC Program - Medical Documentation for WIC Formula and Authorized WIC Foods?
To fill out the documentation, healthcare providers should complete the form by providing the participant's details, specifying the medical condition, and indicating the required formula and food items based on medical necessity.
What is the purpose of Michigan WIC Program - Medical Documentation for WIC Formula and Authorized WIC Foods?
The purpose is to ensure that WIC participants receive appropriate nutrition through specialized formulas and foods necessary for their health conditions, while also maintaining program integrity and compliance.
What information must be reported on Michigan WIC Program - Medical Documentation for WIC Formula and Authorized WIC Foods?
The information that must be reported includes the participant's demographic details, the specific medical condition, the recommended formula and food items, and the healthcare provider's contact information and signature.
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