Insurance portal says covered, pharmacy says nope — what am I missing?

Honestly, my plan’s online cost tool quoted $25 for a 30-day fill in January; the pharmacy ran it and got $437. I’ve spent three lunch breaks on hold, and the rep keeps saying the prior auth is “in process” whie my prescriber’s portal shows it was submitted 11 days ago. I’m not looking for a workaround or a dosing shortcut—just trying to understand how people verify coverage before committing to a telehealth visit. Did you ask for a specific billing code, a formulary exception, or a written denial before paying out of pocket? And did any of that actually change the final number? I’d rather hear concrete experiences than ads.