Medicaid and WIC

I just found out some good news, which may be helpful to others. Becca qualifies for WIC, regardless of our income because she qualified for TennCare (TN's medicaid) by virtue of disability (her prematurity). Yay for free formula! This is especially helpful right now, as I've decided to leave my job to be able to focus more on Becca's needs, therapies, etc. Sooo...don't know if this is how it works in other states, but all I had to do was call the health department, give them her info, have them look her up in the system to check her "code" (her reason for TennCare eligibility), and we're a go! We have an appointment with them next week, and then we'll start getting vouchers for formula, cereal, and juice. Since she's past a year and still on formula (and specifically Neosure, which is considered "therapuetic"), we have to have an Rx from the doctor for it, but that was no problem!

Report post

24 replies. Join the discussion

Hi Nancy!

That is great news. I thought it was automatic in every state. We also qualified for WIC, Medicaid and SSI because of D'Lons gestational age at birth. It wasnt until after she made 2 that our income became a factor for the SSI, but we continued to recieve WIC and Medicaid as a secondary insurance. It was awesome. I'm glad Becca qualify for it as well.

Yolonda

PS...I will be sending you another email soon...

Report post

Unfortunately it is not automatic in every state. We live in Georgia and could not qualify for WIC because we didn't meet in the income guidelines. Bascially we made to much money and in GA you have to meet ALL the requirements. This totally sucks seeing as how my Maddie has to be on 24 cal formula and we are having to make it using the 22 cal formula (special instructions per her G.I. doc). This presents a problem because you give up some water each time because you are concentrating it and that is causing her major constipation :-(. We did get Medicaid, however, and are waiting on SSI. I figured out that IF we had to special order her formula that her bill would be about $600 a month right now and that would only increase as time went on. OUCH!! I Think I'm gonna move to TN ..lol

Report post

I get it too regardless of income! They didn't even ask because we have some form of Medicaid called Universal First. We have been getting Alimentum ready to feed also with the formula request form filled out by our GI. It has been saving us $300 per month...woohoo!!

Report post

Wow! I never knew about these programs! Do you think they'd send me cash for grilled cheese sandwiches and Goldfish crackers now??!! LOL!! That is really great that you can get this support. I would have saved a bundle!

Report post

mygirlsmom-

They do give cheese, milk, beans, rice, etc! My husband is dreading the 12 month coming up because they re-evaluate everything and Medicaid does too, but hopefully we'll just switch him over to goat's milk. Sure was nice while it lasted though!

Report post

Oops, I mean when DS is 12 months old!

Report post

Anyone know about the laws in NY? We've been getting conflicting info on WIC, even though we would be eligible for Medicaid due to thw prematurity.

Report post

We took total advantage of medicaid and WIC too. We too are approaching the one year marker.

It's a lot easier to qualify when your little one is in the NICU and your in the ICU.

It was great while it lasted. I think we only bought formula a handful of times. I liked the $200 worth of preemie formula free each month.

Report post

does anyone know how premature the child must be to qualify in TX? My daughter is almost 2, and I am afraid we are too late in thinking about it -- she does require physical and speech therapy, though. I looked around on the website, and took a questionnaire, but none of the info said anything about prematurity or developmental disabilities.

Report post

For guidelines see this web site:
http://www.fns.usda.gov/wic/howtoapply/eligibilityrequirements.htm

Report post

In Texas, if you qualify for SSI based on their low birth weight program (1500 grams or less), then you automatically qualify for Medicaid and your Medicaid status waives all WIC income requirements. Medicaid also has an awesome program where they reimburse you for trips to and from the hospital to see your baby once a day and for all trips to doctor. I think the rate is $0.37/mile. They also reimburse retroactively. You have to FIGHT for the money, but we got around $3,000, which was certainly well needed.

Report post

Wow! Juliasmommy, PLEASE tell us more about the mileage reimbursement program. I'm sure that many of us could use it!!

Report post

It's called the Medical transportation program. Their number is on the back of the medicaid card. You have to get a hospital staff person to sign a form for every day you went to the NICU (such a pain in the rear!!!), but our social worker did it with no complaints even after we were FINALLY discharged. The toll free number you call takes a while, so be prepared for that. But, if they get ugly with you on the phone, you can do a google search for the actual office in Austin. And, Texas Moms, be aware that for reimbursement, you have to send your forms to Austin rather than fax them to San Antonio like the dumb woman told me. There is a pretty tight timeframe for reimbursements, so don't put it off! Hope that helps.

Report post

One other WIC thing, too. The hospital can fill out a medical waiver form for Medicaid so you won't have to take your baby in with you. Their office in Houston was a huge Petri dish of nastiness.

Report post

I live in GA and have a 17 month, 13 corrected, child. She did not qualify for SSI because of our income, they do have a program called Katie Beckett that we are trying to qualify for. She, too, is on high calorie formula but I checked with our health insurance and because it was written as a prescription, it is covered under her benefits. As long as we used their preferred provider (TelDrug/Apria) and got it through them, it was covered 100%. That is also something to look into.

Report post

Blake is a 27 weeker that will be turning one at the beginning part of September. He was put on Neocate at the end of April. Because of the prematurity he does recieve Medicaid and WIC, but from what I was told, he will no longer be eligible after he turns one. This scares the you know what out of me because I really do not see how we will be able to afford the Neocate. Hubby and I both work and make more than what our state says that we can for WIC, but I can't afford the $46 a jar for the formula. Due to Blakes feeding issues that started in February he is not even on baby food or cereal right now. UGH! I know that the formula was ordered originally with a script through Kroger, but will my BC/BS pay for it???

Report post

Medic311-

According to my friend that works at our GI office, BC/BS rarely pays for formula. It has to be a complete medical necessity and she said even babies with G-tubes sometimes get denied! It's terrible. However, it's worth a shot! She also said that you must show them that you got denied from WIC. Good luck!

Report post

so i have a question where my son was a preemie would he qualify for SSI?

Report post

We live in MN (babies born in SD, but I don't think that makes a difference) and we automatically qualified for WIC due to their birth weight, qualified for SSI while they were in the hospital, and qualified for Medicaid (automatic when a baby gets SSI and WIC) until they were 6 months old all without having to apply and present income.

Report post

Sorry, Tenncare does not do mileage reimbursement! I have tried and tried without luck. The boys had mileage reimbursement with TEIS, but that is ending this month because Medicaid will provde transportation. But, Tenncare's only transportation is where you call and someone picks you up. Can you really see me transporting two two-year-olds, two car seats, diaper bag, etc to every appt? Oh, and you are usually late and wait hours afterwards for a pick-up. And, if only one child has an appt, the other can't come with! Ha! I went all the way to Nashville and the head of TEIS with the transportation thing. In the end, the lady in charge for the Memphis Delta area reminded me that I need to call three days in advance for transportation with Tenncare. Did you not just hear how impossible it is with two toddlers? (Then the boys' service coordinator suddenly found someone for in home therapy after I had been asking since last August to be put on waiting lists. As the place is primarily for the elderly, it would not lessen my trips to therapy as OT is with speech, the in-home can't be for feeding, and the transition would lead to regression, I told them no. Argh!) So, don't get excited on mileage reimbursement with Tenncare. Tenncare actually told me that if I have a working car I am not eligible for transportation because I have my own--even if I don't have gas! BUT, if you find out differently, please let me know!

BTW, when you get cheese for WIC, enjoy! We in no way can eat four lbs of cheese a month. It's a joke at church that for every get together I bring cheese!

I'm still fighting Timothy's SSI. He was turned down a second time. They have NEVER looked at the medical (only the developmental) and his asthma alone qualifies him! Ironically, Nathaniel was approved last October (I applied for both boys in July of last year) and he has the less severe asthma and the less severe developmental issues. We have Tenncare and WIC because I had to quit working because of the boys' asthma.

I am glad you are able to get this formula assistance! Since I wasn't able to pump enough, it was vital for us!

Report post

This discussion is closed to replies. We close all discussions after 90 days.

If there's something you'd like to discuss, click below to start a new discussion.

Things you can do

Discussion topics

Preemie links and resources


Narratives from the NICU -- Read the special report

Community leaders