when you say "mandate" do you actually have a copy of the FEHB policy letter?
You can find it online. Us Office of Personnel Management, Office of Insurance Programs, FEHB Program Carrier Letter (All Carriers) Letter No. 2001-27. It's not a case by case policy. That was the whole point of making the policy. Carriers were being inconsistent in applying their own standards vs FDA standards of what is "experimental and investigational."
look up the "mandate" read the policy letter!
Being a federal employee, you have a stronger argument than most. There is a guy a long time ago that won this argument when his private insurer denied him, against Fed policy. He got is surgery. do a "find" for FEHB you'll probably find him.
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Injured 9/01
Annular tears L4/5 & L5/S1
denied adr by insurance for 2 level charite as well as hybrid fusion at L5/S1 with Charite at L4/5.
New ins paid for 2 level lumbar prodisc surgery on 4/7/08 (at age 39) with Dr. Westerlund, at Core Orthop
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