A specialist copay of $55 versus $25 means very little in isolation. Connect it to how the client actually uses care, and the difference becomes real.
Example: two specialists, regularly
Plan A — specialist copay × 2 visits$55 × 2 = $110
Plan B — specialist copay × 2 visits$25 × 2 = $50
Difference for those two visits$60
Connect it back
"You told me you're seeing specialists regularly. Would lowering what you're paying when you see those doctors help you?"
Keep it honest
This is an illustrative comparison based on the client's expected utilization and verified plan costs — not a guarantee of savings. Don't exaggerate a hypothetical based on visit counts the client hasn't confirmed.
The formula
Small Difference
×
Frequent Use
=
Potentially Meaningful Difference
Where this applies
Specialist visits
PCP visits
Hospital admission
Outpatient procedures
Urgent care
Prescription copays