A video call with a doctor probably won’t cut it for a broken ankle. But what about a strange rash on your arm, a check-in for a prescription refill or help with anxiety?
PYMNTS Intelligence’s latest research finds that roughly 3 in 10 Gen Z and millennial patients had their most recent healthcare visit remotely. This is just one example of how healthcare is quietly undergoing a digital revolution. Another example: Nearly 1 in 5, or 18%, of consumers now use health-tracking apps or devices, such as Apple Health or FitBit.
The digital shift in healthcare is far from seamless, however. Most consumers report challenges in the payment process, including a lack of digital payment options, insurance barriers and billing issues such as unexpected charges or difficult-to-understand statements. While younger consumers lead the way in integrating technology into their healthcare experiences, they also encounter more challenges in the payment process. Nearly 7 in 10 Gen Z patients encountered at least one snag when paying for their latest healthcare service, compared to just 18% of baby boomers. Paying is the new pain in medical services.
These are just some of the findings detailed in “Three in 10 Gen Zers and Millennials Use Telehealth. But Paying the Doctor Is Full of Friction,” a PYMNTS Intelligence special report. This edition examines healthcare preferences and draws on insights from a survey of 2,021 U.S. consumers conducted from April 1, 2025, to April 21, 2025.
A Generational Split
Roughly 3 in 10 Gen Zers and millennials had their latest healthcare visit remotely.
Remote healthcare delivery is rapidly gaining traction. Within the last three months, just over 1 in 5 individuals had their latest healthcare visit remotely through “telehealth” services, while 79% did so in person. Phone and video calls were equally popular for remote visits, each at 8%, while email accounted for 5%. Zillennials had the strongest preference for remote visits, at 34%, followed by millennials (31%), Gen Zers (30%) and bridge millennials (29%).1 For Gen X, this drops to 20%, roughly matching the sample average. Meanwhile, just 6% of baby boomers accessed healthcare remotely, revealing a sharp divergence between consumers aged 60 and older and their younger counterparts.
Of course, remote delivery is more compatible with certain healthcare services than others. Mental health is a natural fit, with 52% of all visits now conducted remotely, primarily through video calls. Notably, a large share of patients chose remote treatment for services that traditionally required in-person visits. This includes 34% for retail health clinic visits, 21% for urgent care, 15% for emergency room and 14% for primary care. These figures underscore just how far the shift to remote-based care has already come. Only in the case of specialty care do remote visits remain rare, at just 4%.
Healthcare services vary across generations, yet share some commonalities.
Regardless of age group, about 7 in 10 consumers had at least one healthcare visit in the last three months. The services they used vary substantially across generations, however, with three trends standing out most.
First, specialist visits increase with age and are far more frequent for baby boomers, at 27%, than for younger cohorts. Second, Gen Zers are much more likely to visit urgent care than consumers in older age brackets, including zillennials and millennials. This may be related to a lack of health insurance — 26 million Americans had no health insurance in 2024, according to the Centers for Disease Control and Prevention, nearly all of whom were under the age of 65. Third, younger consumers use mental health services far more frequently than their older peers. Roughly 1 in 5 Gen Zers, zillennials and millennials did so, compared to 12% of Gen Xers and 5% of baby boomers.
Paying the Bill
Gen Z consumers are the most likely to encounter challenges in paying for healthcare.
Many consumers, particularly younger ones, struggle to navigate healthcare payments. For their most recent service received, 38% of Gen Zers say the payment process was moderately hard or difficult. This drops to 30% for zillennials and continues to decline with each older age group. Just 7% of baby boomers report that the process was not smooth.
In large part, this divergence likely reflects the role that Medicare plays in simplifying payments for enrollees. The government insurance program currently has 68.5 million individuals enrolled, 91% aged 65 or older. By contrast, navigating private insurance plans and their coverage can be notoriously challenging, even without considering financial challenges in paying.
Payment issues are common across most healthcare services. Consumers report friction the most frequently for emergency room visits, at 34%, followed by mental health, at 27%. Both services are used more frequently by younger individuals. More than 1 in 5 consumers also found it at least moderately challenging to pay for visits to retail health clinics and urgent care.
Overall, 44% of consumers reported at least one issue when paying for their latest healthcare service. Echoing the findings above, younger consumers are the most likely to experience problems: Nearly 7 in 10 (68%) of Gen Zers, 67% of zillennials and 63% of millennials cite at least one challenge. Gen Xers, at 37%, and especially baby boomers, at 18%, are much less likely to have difficulties. Transparency and communication issues, such as unexpected costs and unclear billing statements, were the most frequently cited areas of concern for all age groups. Many consumers also encountered payment method limitations, including a lack of digital payment options, and insurance-related barriers related to what an insurer covers.
Digital Healthcare Tools
More than 6 in 10 consumers report using digital tools to manage healthcare.
Digital tools such as online patient portals and health tracking apps have become a central part of today’s healthcare industry. This is particularly true for younger consumers. Between 75% and 77% of Gen Zers, zillennials, millennials and bridge millennials all used at least one app or device in the last year. Adoption is high among older consumers, too, at 66% for Gen Xers and 62% for baby boomers. Most of these individuals have shared their personal healthcare data with their providers.
Provider portals are the most popular tool, used by 36% of consumers, followed by online appointment systems, at 25%. In both cases, rates vary relatively little across age groups — though interestingly, baby boomers are the likeliest to use provider portals. In large part, this is likely because many individuals in this age group access their Medicare benefits online. Meanwhile, baby boomers and Gen Xers are significantly less likely than their younger counterparts to use health tracking tools, medication management apps and digital payment systems. Among consumers who use monitoring apps or devices, 31% do so daily, and another 19% do so weekly.
Increasingly, health monitoring apps and devices give users the ability to share data with their healthcare providers. Among respondents who have used these tools in the last year, 55% did so, and 24% did not but would have liked to. Only 21% say they are glad they did not share their personal health data with their providers. These trends remain constant across generations, indicating that while adoption rates vary with age, the willingness to share data with providers largely does not.
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Methodology
“Three in 10 Gen Zers and Millennials Use Telehealth. But Paying the Doctor Is Full of Friction” is based on a survey of 2,021 U.S. consumers conducted from April 1, 2025, to April 21, 2025. The report examines preferences for obtaining healthcare, as well as the ease or difficulty in paying for those services and treatments. Population weights based on the U.S. census are used to ensure the analysis is representative of the U.S. adult population.
1. PYMNTS Intelligence uses the following birth years and age ranges for generational cohorts: baby boomers: born in 1964 or earlier and turning age 61 or older in 2025; Generation X: born between 1965 and 1980 and turning 45–60; millennials: born between 1981 and 1996 and turning 29–44; bridge millennials: born between 1978 and 1988 and turning 37–47; zillennials: born between 1991 and 1999 and turning 26–34; and Generation Z: born in 1997 or later and turning 28 or younger.↩
