JPOUCHER21, I’ve previously posted in detail about my year-long successful process of getting my insurer to cover VSL #3 DS. I included the text of the ultimately successful, annotated letter that I ghost-wrote for my gastroenterologist, and a link to the detailed policy that my insurer created regarding when they would cover it. You should be able to find these with a careful “Advanced Search” here, but send me a private note if you still can’t find the posts. After you exhaust your formal, written appeals with your insurer you have recourse with your state’s Department of Insurance. If you’re still in Colorado that would be at https://www.colorado.gov/pacif...a/health-insurance-0
Make very sure to appeal on the basis of medical necessity rather than a contractual review. You don’t have a chance of winning in an argument about a contractual exclusion.
Although Visbiome is the original, well-studied formula, I have elected not to try to have the complicated conversation with my insurer about that. Instead I just use VSL #3 DS, which is the name of the product in all of those studies.
If you don’t already have chronic pouchitis then this will be an uphill climb, I think. Treating a serious condition is one thing, but trying to prevent or delay a condition you may never get is less compelling. Good luck!