Discovery, penny wise pound foolish

I suffered a Pulmonary embolism mid June and have been supplementing medical costs for this chronic condition from my own pocket. I refer specifically to Clexane which every three days costs R 1 300+-<br> The medical Aid are refusing stating \it is not included in the Scheme's defined benefits"and that they make use of \"" clinically appropriate and cost effective\"" treatments\"". <br> My Doctors instructions are continue with Warfarin but should my INR drop below 2 i should immediately get 3 days of clexane followed by testing on the 4th day and repeat until it goes above 2. Bear in mind that when my INR drops the effect is that i struggle to breathe as new clots begin lodging themselves in my lungs and i must stay at home to recover if i do not get the clexane and my INR continues to drop (as it is doing currently) the inevitable outcome will be a hospital visit.<br> From this I deduce the following:<br> Keeping me alive is both clinically inappropriate and not cost effective!<br> I accept that it may not be in the defined benefits but i simply do not understand that a R 50 000 rand week long hospital visit (my unpaid sick leave) is in any way cheaper than the R 6 500+- i have paid from my pocket."""