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Texas WIC Contract Formulas

Federal regulations require all WIC programs to obtain a formula rebate contract to help contain costs. The milk-based infant formulas are provided by Abbott Nutrition, makers of Similac. Soy-based formula will be provided by Gerber.

Contract Formulas

The following formulas are available without medical documentation.

Milk-Based: Similac Advance (powder and concentrate

Milk-Based: Similac Advance (powder and concentrate)



Soy-Based:Gerber Good Start Soy

Soy-Based:Gerber Good Start Soy. Available upon request, for severe lactose intolerance, cow’s milk allergy, or failed trial of both milk-based contract formulas

The following alternate contract Similac Products can be provided with a medical request:

The following formulas can be provided with a Texas Medical Request Form when Similac Advance is not tolerated:

Similac Sensitive (after April 1,2014)

Low-lactose

 


Similac Sensitive: low lactose

Similac for Spit-Up (after June 1, 2014)

Milk-based, lactose-free, added rice starch

 

Similac for Spit-Up

Similac for Spit-Up (after June 1,2014)

Milk-based, lactose-free, added rice starch

 

Similac Total Comfort

(Note: All formula requests for women or children 12 months of age or older require medical documentation. This includes requests for both contract and noncontract formulas. Use the noncontract or metabolic formula request forms - see links below.)

Requesting Noncontract Formulas

Requesting Metabolic Formulas

WIC Formula and Food Benefits – WIC is a supplemental food program. This page lists the food and formula benefits WIC participants receive each month.