New Infant Formula Contract

Effective October 1, 2016, Abbott Nutrition will hold the contract to provide standard formula for Massachusetts WIC infants that are not exclusively breastfeeding. Similac Advance and Similac Soy Isomil will be the state contract formulas, replacing Enfamil Infant and Enfamil ProSobee Soy.

WIC families can talk with their local WIC nutrition staff for more information. Medical providers can visit the Providers link from the WIC home page for further details. Additional materials will be posted in the coming weeks.

Massachusetts WIC-Approved Formulas
**Through September 30, 2016**

Enfamil Infant and Enfamil ProSobee (soy) are WIC's standard infant formulas.

WIC also provides special and metabolic formulas for participants with special medical needs. A completed Request for Special Formula and Food form requesting a special or metabolic formula with a nutrition-related ICD code must be provided outlining the patient’s qualifying medical condition(s) warranting need prior to issuance.

MassHealth is the payer of first choice for special medical formulas for WIC participants who are MassHealth members. While waiting for MassHealth approval, WIC will provide one month of benefits for the prescribed formula from WIC (after the medical provider has completed the Request for Special Formula and Food form) and will act as a safety net for families should the process take longer. WIC staff can guide WIC participants and medical providers through the process of receiving special or prescription formulas through MassHealth insurance. (Reference ‘For Healthcare Providers>What if my patient needs special formula?’ at www.mass.gov/wic). MassHealth members requiring Enfamil Gentlease and Enfamil A.R. will receive these formulas through WIC without needing to pursue prior authorization from MassHealth. A Request for Special Formula and Food form is required for Enfamil A.R. before issuance will be approved.

Note: For Type, P = Powder, C = Concentrate and R = Ready-to-Use (RTU) or Ready-to-Feed (RTF). WIC does not permit the issuance of RTU or RTF formulas when more than one type of a formula is available (i.e., if available in Powder or Concentrate) unless there are concerns regarding safe preparation of the formula.

FormulaTypeFormulaType
3232APNutramigen (liquid forms)C, R
Boost Kid Essentials 1.0RNutramigen with Enflora LGGP
Boost Kid Essentials 1.5ROsmolite 1.5R
Boost Kid Essentials 1.5 with FiberRPediaSureR
Bright Beginnings (soy)RPediaSure with FiberR
Carnation Breakfast EssentialsRPediaSure 1.5R
EleCare InfantPPediaSure Peptide 1.0R
EleCare Jr.PPeptamen JuniorR
Enfamil A.R.P, RPKU-2P
Enfamil EnfaCarePPKU-3P
Enfamil GentleasePPregestimilP
Enfamil InfantP, C, RPulmocareR
Enfamil ProSobee (soy)P, C, RRCFC
EnfaportRSimilac Alimentum HypoallergenicP, R
EnsurePSimilac ExpertCare NeoSureP
Ensure PlusRSimilac PM 60/40P
KetoCal 4:1PSimilac SensitiveP
Meyenberg Evaporated Goat MilkCSimilac Special Care 30R
MSUD-2PVivonex PediatricP
Neocate InfantPXPhe MaxamumP
Neocate Jr.P