7 in 10 Gen Zers Find Paying for Healthcare a Headache

Patients often visit the doctor with a headache and leave with a new one. On the one hand, the digital transformation of healthcare is accelerating, with younger generations at the forefront of using remote telehealth visits and digital health tracking tools like Fitbit and Apple Health. On the other hand, paying for doctors visits is rife with pain points, from billing statements that require a Ph.D. in math to decipher and surprise charges to a lack of ways to avoid having to whip out a checkbook to settle the bill.

PYMNTS Intelligence’s forthcoming “Generational Pulse” report highlights how the healthcare industry’s technological shift to digital health services has a festering sore spot: Payment friction, particularly for Gen Z and millennials. While these consumers are more likely to use remote healthcare and digital monitoring through apps, they also report greater problems when navigating the complexity of healthcare payments.

Telehealth is no longer a niche offering. According to the PYMNTS Intelligence survey of 2,021 U.S. consumers conducted in April 2025, about 3 in 10 Gen Z and millennial patients had their most recent healthcare visit done remotely, either by video call, phone or email. This marks a sharp generational divide: While 30% of Gen Z and 31% of millennials used telehealth for their latest visit, only 6% of baby boomers did the same.

The data, the latest in the “Generational Pulse” series, highlights that remote healthcare is especially popular for mental health services, with 52% of all such visits conducted remotely. But services that are traditionally in-person are also taking on a virtual dimension. More than one-third of visits to retail health clinic visits, 21% to urgent care and even 15% of emergency room visits were handled remotely. Only specialty care remains predominantly in-person, with just 4% of such visits occurring virtually.

What’s striking about the digital healthcare revolution is how antiquated, often-manual billing systems haven’t kept up with advances in virtual diagnosis and treatment.

The report, “Why 30% of Gen Z and Millennials Use Telehealth — And What They Find Painful,” reveals that nearly 7 in 10 Gen Z patients (68%) encountered at least one issue when paying for their most recent healthcare service, compared to fewer than 1 in 5 baby boomers. The most common snags included a lack of digital payment options at the provider’s office, insurance coverage hassles, unexpected charges and difficult-to-understand billing statements. These issues are most pronounced for emergency room visits and mental health services.

Why do boomers and older seniors report fewer payment headaches? The report suggests that Medicare’s streamlined payment process likely helps older consumers avoid many of these issues. In contrast, younger generations, who are more likely to be uninsured or reliant on private insurance, face a labyrinth of payment complexities. According to the Centers for Disease Control and Prevention, 26 million Americans lacked health insurance in 2024, nearly all under the age of 65 — further compounding the payment friction for younger cohorts.

Payments also haven’t kept up with the digital revolution in patient portals, health apps and wearable devices. More than 6 in 10 consumers across all age groups report using digital tools such as online patient portals and health-tracking apps to manage or monitor their care and health. Not surprisingly, younger consumers are the most avid, with at least 3 in 4 Gen Zers, zillennials, millennials and bridge millennials using at least one digital health tool in the past year.

But aging Americans aren’t far behind, with more than 6 in 10 Gen Xers and boomers report logging in to their profile at their doctor’s office, strapping on an Apple Watch to monitor their heart rate and sleep or tracking their diet through apps like Noom. Boomers are the most likely to use provider portals, likely reflecting their engagement with Medicare’s online services. Meanwhile, younger consumers are more likely to use health-tracking and medication management apps, as well as digital payment systems.

The payment pain highlights a critical need for healthcare providers and payers to innovate not just in care delivery, but also in payment systems, making them as seamless and user-friendly as the digital health tools consumers now expect.

Key takeaways:

• Telehealth is mainstream for younger generations: About 30% of Gen Z and millennials had their most recent healthcare visit remotely, compared to just 6% of baby boomers.
• Consumer use of digital health apps and other tools is high, but payment friction festers: Over 75% of younger consumers use digital health tools, yet nearly 70% of Gen Zers report challenges when paying for their care.
• Payment complexity is a generational pain point: A lack of digital payment options, insurance barriers and billing transparency disproportionately affect Gen Z and millennials, underscoring the need for payment innovation in healthcare.

Read more:

A Dose of Digital: How Modernizing Payments is Revitalizing Healthcare

42% of Small Healthcare Practices Sent Paper Checks During Past Year

Healthcare’s Digital Payments Push Battles Rising Fraud and Falling Margins

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