Wic - Yukon,OK

"Beneficial" is not the same thing as "medically necessary"- take a look at how the doctor wrote the release. If the specialized formula is "necessary" then you can likely appeal the decision. If the formula is "of benefit", then it's not necessary and they can decline it.

Call the company that makes the formula and send them a copy of the medical statement. Sometimes they will send you "samples" or extra coupons!

I understand being disappointed but please remember that taxpayers are funding this program for your children. Maybe it doesn't work perfectly but having your children's food supplemented by other people's hard work and pay this long is a lucky thing in my opinion.

When my twins were babies they were on special formula and one was on Nutramagin and yes it is very expensive. We were on WIC and every time we went in to get the checks I had their doctor write out the prescription for Nutramagin and we would get it. So everyone doesn't bash me, I was working fulltime and my husband was as well but it still wasn't enough to feed 2 preemie babies at once. Wic is out there to help out families that need it. I would appeal the decision. Ask your doctors office if they can get into touch with the Enfamil rep to see if they can get you some formula to help out while you are appealing the decision. Since my twins has issues with digesting regular milk they were on formula until they were 18 months old.

Did you ask questions about this when you were there? If they are sticking by their denial then I would call the formula provider and see if they can send some checks out to help offset the cost of the formula.

How old is your son?

First off I want to say I feel for you and people can be very judgmental on here.
Pam R is just rude.
I have problems getting checks every three months even though my doc has filled out their forms. Every three months I have to get it filled out again even though everything is documented that it is a necessity. I don't have the ability to breakdown the protein in dairy. There for don't get a lot of much needed things in my diet.
I would appeal and get your doc to write a letter on you behalf stated why it is needed.
I work full time at my area hospital and my husband is home with our baby. He worked when she was first born but we were spending to much on gas and her daycare with him working. We actually weren't able to pay bills when he was working so when he was laid off it was kind of a blessing.
Good luck

I don't see anywhere on here where you say how old your son is, so I'm answering under the assumption that he is at least 6-9 months old....My question is this...Is it possible your son needs more solid food? I have three children, all whom I nursed for at least a year. I tried to introduce rice cereal to my daughter, who is my youngest, at 6 months, and she responded by puking violently...So I backed off, figuring she just wasn't ready for solids. At 7 1/2-8 months the same thing happened. I asked her pediatrician what to do and he said take her straight to table food....(She is 15 months now and does not have any allergies - rice is not known to be an allergen)...I don't know why, but It worked great. I went to the Baby Depot/Burlington Coat Factory, and got a manual baby food grinder, complete with a carrying case, and spare parts for less than $15...It was awesome! I could take anything my family was eating, at home or anywhere, and put it in, turn the handle, and get perfectly textured baby food...We gave her veggies, chicken salads, pasta, etc., and to this day she is still my best eater. I just thought it may be helpful to give less formula and more solids since the formula alone, even if wic approves, doesn't seem to be doing the trick.

We went thru this with my grand daughter in Arkansas. Apparently there was a change in the Nutramigen name - it became Nutramigen with Lipil. The WIC office then had to require an updated prescription with the new name - we had to do this even though we still had 2 months on the current prescription. No communication regarding this from ANYONE until we went to our monthly voucher pick up. It is my understanding that SNAP will pay for formula if you qualify for that. You might also want to contact customer service and tell them you need coupons. They love to send out $5, etc off coupons. My grand daughter is 2 and is still lactose intolerant. Lactaid is terribly expensive and only lasts 5-7 days once opened. We now use almond milk - a little cheaper and it won't sour in a week!

I think this may have to do more because of his age. How many checks left do you have for the formula. He is going to be off formula in a few months and from what it sounds like from previous posts he is still having the issues even on it. It is very, very hard to get WIC to cover special formula for a reason...it has to be Really, really needed and proven to be working. If WIC wont cover it if it is Doctor prescribed some Medical insurances will cover it for babies but he is growing out of this age group real quick. To my knowledge WIC can deny as long as they feel that it a valid denial. Sry you are dealing with this it is hard when a child has a medical issue. My son went through silent reflux and we had to save in other areas so we could afford the formula that he needed sometimes that is hard but you do what you have to do.

When you are on public assistance, they make the guidelines and can "override" almost anything that does not adhere with their policies. You could probably appeal the decision and request in the interim that your child continue to be given the same formula.

I would also suggest writing and/or looking on line so you can contact the formula company. There's probably a 800 number or url address on the container. Maybe they will send you a free case.

Blessings.....

I know how you feel. Nutramugin is horribly expensive. I had one lady in my child care center who was spending several hundreds of dollars per month on it after WIC too.

I think the woman was out of line. If the baby is having a health issue where they feel he is not doing well on the formula then they need to pick up the phone during the appointment and have a conversation with the doc, then the 2 of them make sure the options are what they should be. The doc will take the call since it is from an agency regarding a patient.

If he is not gaining weight he will have to do something else. I feel she would not have been this drastic if he was growing according to the acceptable guidelines. You need to have an open mind to accept it may be time to try other things. I would suggest you ask the doc about going to a specialist. Or call the insurance provider and get a recommendation of what kind of doc to make an appointment with. Perhaps an allergist or a gastro doc could really help. There are other options that might work out better. She should have still handled it differently, maybe by only giving you a one month voucher and telling you to have an appointment with the doc because she was really concerned. Then if the doc still agreed to come back to get the other 2.
******************************
I get annoyed at people too who say rude things to people who use the state for assistance. Excuse me, I worked many many years as an adult and now I work 3 part time jobs and my husband draws SSDI. We still get WIC and get food from the monthly food bank. We have to, to be able to balance our finances and keep gasoline in the car, food on the table, and be able to have electricity, natural gas, and hot water.

I hope someday they are in need or have the opportunity to ask for help. It's not a hand out, it's a needed service that is part of the budget set up by the government.

One time in Relief Society on of the teachers who was talking about the church welfare program said she would rather go hungry than ask for help...how prideful. She didn't even think/or know maybe, that many of the sisters sitting in the meeting were having to use the food program or financial assistance the church provides due to massive layoffs and/or family illnesses going on at that time. I can't tell you how many of those women dropped out of the church over the next few months. Most of those women have never attended any other church. How sad one sisters opinion about taking hand outs influenced so many to turn away from church.

I don't believe that they have to agree to give you the formula unless you have a medical diagnosis for ex. Your child has a dairy and soy allergy that has been documented by testing.

Perhaps you can get a prescription for your insurance.

you need th doctor to fill up the paper that says he is in nee of special formula ask for the form at your wic and give to the doctor

I just checked the govt site for WIC, and Nutrimugin must be prescribed (not just a doctor's release) AND is only available until a child is 12 months old UNLESS it is medically necessary and then up to 5 years.
Specifically ask WIC for the proper forms or what they require.

You can appeal, and meanwhile get a Rx for it. Also, if your child drinks more than you get coupons from WIC you are on your own to purchase the extra, and free to use insurance. It is a "supplemental" program and they do state that.

And, they are free to deny a doctor's release, they use them as guidelines but are not "bound" by them.

God bless

You need to appeal the decision.

"Not gaining enough" so we'll take away the ONE formula that allows him to gain any weight at all. So they want him to LOSE weight and be hospitalized for vomiting, and then failure to thrive?

This needs to be brought up in the appeal. Your doctor will probably need to write out that your son is allergic to/sensitive to x,y,z... and that not being on nurtimigen causes a, b, c. That the options are nutrimigen or hospitalization.

((BTW... My son was a big eater/ very active boy as well. 64oz of enfamil lipil premixed per day. The way he grew was to c*** up, and shoot up. So he'd often be "ribs and vertebre" poking out, but then would c*** up again and be "obese". That's just the way he grows. It's not the MOST common way babies grow, but it's not uncommon, either. When our ped was out I'd often have to refer new docs to his CHART so that they could see that whether he was "severely underweight for height" or "obese for height" that's just what he did. But the new doctor's initial reaction was always one of "OMG! You need to increase/decrease" if they caught him at either end of the spectrum. Point in sharing this is that height to weight, your son may be very very low BUT if he's just had a growth spurt, that's also totally normal and his entire diet doesn't need to be redone if in a month, he'll be normal to roly poly again.))

have you tried having the doctor write out a script for nutramigen and pick it up at the pharmacy? call your health insurance provider (state assistance or say tufts, bcbs, etc..) and see if you had a letter of medical necessity submitted by the doctor or gastroenterologist if they would pay for it?? you might have a copay at the pharmacy picking up a prescription vs using wic checks.. i never heard of wic denying that with doctor order... good luck!