For Health Care Providers
All MaineCare Prior Authorizations should be forwarded to WIC.Maine@maine.gov Due to the COVID-19 pandemic, we will have very limited access to our fax machine. Thank you for understanding.
COVID-19 Announcement (PDF)
WIC provides breastfeeding counseling, support and education to all pregnant and breastfeeding women. WIC also provides loaner breast pumps to breastfeeding mothers.
Infants who are not exclusively breastfed can be provided formula, up to the WIC Maximum Monthly Amount (Excel). If a non-standard formula is medically indicated, please complete the Prior Authorization form below.
Medical Documentation and Prior Authorization Form
This form is required before non-standard/medical formula can be provided to WIC participants. Health care providers, please follow these steps:
- Download the form in Word or PDF format
- Fill out form
- Fax it to your local WIC office or to the State WIC Agency by e-faxing to firstname.lastname@example.org or traditional fax at 207-287-3993.
Former Standing Order Forms
The standard Abbott Similac contract formulas that were previously 19kcals/oz (Sensitive, Total Comfort, and Spit-Up) have been reformulated to 20kcals/oz and no longer require our Standing Order Form.
OB-GYNs and Maine WIC: a vital partnership
We don't have to tell you twice…Appropriate prenatal care for your patient is critical for health pregnancy outcomes. Let WIC help. Referring your patients to WIC for a continuity of prenatal and postpartum care helps ensure moms and babies are receiving breastfeeding support, good nutrition guidance and the critical opportunity to raise healthy families. Call us at 207-287-3991 or email email@example.com to request copies of our WIC brochure to assist in referring patients to WIC or copies of our WIC infographic to share the importance of WIC with your colleagues and staff.
Health Care Provider Food Insecurity Toolkit
Food insecurity is a real issue for Maine families. Health care providers can help to identify those families who need assistance with this most basic of needs. The Health Care Provider toolkit can help you in your work with the patients you see every day.
The kit includes:
- USDA WIC Overview/FAQ (PDF) Common WIC questions and answers
- WIC Program Snapshot (PDF)
- Maine WIC Outreach Brochure (PDF) Includes local WIC office contacts
- WIC Food Referral Chart (PDF) Includses referral websites and phone numbers
- Maine Infant and Toddler Profile (PDF) Single page outline for referring patients to WIC
- Maine Physician Mailing (PDF) Single page outline for referring patients to WIC
- Maine WIC Fact Sheet (PDF)
If you would like hard copies of any of these materials, do not hesitate to contact the Maine CDC WIC Nutrition Program office at 207-287-3991 or send your request to us at /dhhs/mecdc/population-health/wic/contact.shtml.
Thank you for all you do to assist in identifying families in your practice who may benefit from Maine's nutrition programs.
Maine CDC WIC Nutrition Program Formulary - Updated October 2020
The Maine CDC WIC Formulary includes standard and medical formulas. All prescription formula request for items not included on our Formulary are evaluated biannually through an internal submission review process. These reviews take place in June and January. If your organization has a request for an exempt formula or qualifying nutritional, please forward the formula information and include the UPC and formula product label (manufacturer product website page, if possible) to firstname.lastname@example.org. Only contract brand standard formulas can be provided.
- Standard Contract Formulas (Cow's Milk, Soy and Added Rice Starch) (PDF)
- Preterm, Low Birth Weight and Failure to Thrive Formulas for Infants (PDF)
- Hypoallergenic and Malabsorption Formulas (PDF)
- Failure to Thrive Formulas for Children (PDF)
- Miscellaneous Medical Formulas (PDF)
Provision of Ready To Feed (RTF) formulas:
WIC staff may provide ready to feed (RTF) infant formulas for a WIC participant only when assessment determines that at least one of the following conditions exists:
- The participant's household has an unsanitary or restricted water supply or poor refrigeration
- The person caring for the participant may have difficulty in correctly diluting concentrated or powdered formulas
- The formula is only available in ready-to-feed form.
Participants with a prescription for a medically necessary formula (non-standard formula, exempt formula, WIC-eligible nutritional) may be provided RTF formula for the following additional reasons:
- The ready to feed form better accommodates the participant’s condition
- The ready to feed form improves the participant’s compliance in consuming the prescribed WIC formula
For information on RTF forms of specific formulas, consult the appropriate section of the WIC formulary.
- Monday - Friday 8am-5pm
- Phone: (207) 287-3991
In-state Toll Free:
TTY: Maine relay 711
- Mailing address:
11 State House Station
Augusta, ME 04333
Phone Numbers for
your local WIC clinic
- Auburn: 207-795-4016
- Augusta: 207-626-6350
- Bangor: 207-992-4570
- Bath: 207-442-7963
- Belfast: 207-338-1267
- Biddeford: 207-283-2402
- Calais: 207-454-3634
- East Wilton: 207-645-3764
- Ellsworth: 207-667-5304
- Machias: 207-255-8280
- Portland: 207-553-5800
- Presque Isle: 207-768-3026
- Rockland: 207-594-4329
- Sanford: 207-459-2942
- Skowhegan: 207-861-3593
- Waterville: 207-861-3580