Confused by Pharmacy Benefits and Deductible

I switched jobs last year and this is my first time dealing with my pharmacy benefits (caremark) being separate from my health insurance (aetna) and I'm having trouble navigating it. I have an expensive medication where the generic is never in stock, but name brand is covered, but at significantly higher cost after a prior authorization from my doctor. Even though the medication is almost prohibitively expensive, I thought I would be able to pay for it until I hit my relatively low deductible after a few months and higher coverage kicks in, but after paying the hundreds of dollars for this medication I checked my account and only $30 dollars went to my deductible with the tag "Pharmacy Benefits Manager". Also from my understanding, it was Aetna that required the prior authorization since the pharmacy I used didn't have my Pharm benefits card on file yet, which doesn't make sense if they aren't the ones covering it? Is this normal and is there anything I'm missing or I can try to do to improve this situation?

submitted by /u/danman8001
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