I don't know too much about it other than that it is an uphill battle. Two thoughts though - 1) Indication for the lenses probably has a lot to do with how they view it. For example, for many people sclerals are an alternative to a corneal transplant. While not all insurers are on board yet, for those that are, it's kind of a no-brainer, because it's lower cost and lower risk for repeat (increased cost) than transplant. Dry eye pain on the other hand - especially if the doctor is not seeing horrendous damage to the surface of the cornea - is a different matter in terms of alternative treatments that they will be thinking of. 2) The BSL, or more properly BOSP (boston ocular surface prosthetic) is FDA approved for treatment of some corneal diseases so I'm guessing that it may be less of a battle with insurers.
If anybody has info to the contrary feel free to set me straight - I don't know too much about this part of it.
The Dry Eye Zone