Healthcare on Hold: Why 1 in 4 Gen Z Consumers Skip the Doctor

Younger people tend to be healthier populations, and thus less in need of treatment for the often-expensive conditions that come with aging. Yet healthcare costs are disproportionately likely to strain a young consumer’s household budget. As insurance premiums and out-of-pocket costs soar, many younger consumers are rethinking their approach to doctors, dentists and therapists. Even for Gen Z individuals with insurance, doctors’ visits are becoming a considerable financial burden.

The generational disparities here are stark. Eight in 10 Gen Z Americans report that medical expenses put at least a moderate stress on their budgets. That’s nearly twice the share of baby boomers who say the same, even though older individuals are more likely to require greater care. Evidence of financial strain comes from PYMNTS data showing that young consumers pay out of pocket for more than one-third of their treatment costs. With many delaying care due to costs, affordability concerns are forcing a new generation to rethink when and how they seek care.

These are just some of the findings detailed in “Healthcare on Hold: Why 1 in 4 Gen Z Consumers Skip the Doctor,” the latest installment of the Generation Pulse series, a PYMNTS Intelligence exclusive Trendscape. This edition examines how medical costs are affecting each generation’s healthcare behavior. It draws on insights from a survey of 2,368 U.S. adult consumers conducted from Sept. 10, 2025, to Sept. 29, 2025. Notably, this survey asked different questions than those in previous editions of Generational Pulse, and so the findings cannot be directly compared.

• Beast of Burden
• Out of Pocket
• Delaying Care
• Read More
• Methodology

Beast of Burden

Whether they get their health insurance through employer-sponsored plans, purchase a policy directly from an insurer or through a marketplace (paying in full or via tax credits), or use Medicare, Medicaid or another government-sponsored program, millions of Americans are feeling the pressure of rising healthcare costs.

For individuals, the average annual premium for employer-sponsored health insurance this year is $9,325 ($26,993 for family coverage), according to KFF. That’s an annual increase of 5% and 6%, respectively, against a 4% rise in workers’ ages and inflation of 2.7%. Johns Hopkins’ Bloomberg School of Public Health said this month that premiums for Affordable Care Act policies were up as much as 59% in the current open enrollment season. KFF calculates premiums will more than double next year if tax credits for “Obamacare” expire on Dec. 31.

Three in 10 Gen Zers and millennials use lower-cost telehealth services, and just over half of all mental health visits are conducted remotely. But that hasn’t cured the financial pain of seeing a doctor, dentist or therapist. Behavioral health costs are soaring at twice the rate of those for other medical treatments, BSI Corporate Benefits says. With more than two in five Gen Zers in therapy for conditions including depression, anxiety and stress, according to one survey, even those with insurance face rising out-of-pocket costs. Claims for behavioral health services spiked 45% between January 2023 and December 2024, PWC data shows.

Four in five Gen Z consumers say healthcare costs are a financial burden.

Across generations, 63% of consumers say healthcare costs are at least somewhat of a financial burden on their household budgets. Among millennials, that figure rises to nearly three in four, and for Gen Z, it is even higher at 80%. What’s surprising is that nearly one in four Gen Z individuals and zillennials say these costs are an extreme or major burden. Such individuals tend to be healthier populations than older cohorts and often lack dependents, suggesting that the treatment and services they do seek are increasingly straining their pocketbooks.

This disproportionate pressure could have several causes. Younger consumers may have bare-bones or no insurance at all, making a trip to the ER for a broken arm a four-figure bill they’re ill-equipped to cover. Or they may have workplace-sponsored insurance but are too early in their careers to have amassed a safety cushion to cover unexpected expenses.

Out of Pocket

Coverage is only part of the financial story, with 30% of healthcare visits carrying out-of-pocket costs.

Consumer health insurance plans aren’t a panacea. Three in 10 Americans paid at least partially out of pocket for their last healthcare appointment. Again, younger generations are bearing the brunt of this financial burden. The share increases to 38% among millennials, 42% among zillennials and 35% among Gen Z individuals. Among baby boomers and seniors, 86% report that their last healthcare appointment was at least partially covered by insurance, compared with only 70% of Gen Z. Nearly one-third of all consumers report insufficient insurance coverage, suggesting that current benefits are not meeting their medical needs.

Delaying Care

Amid healthcare cost pressures, one in four Gen Z individuals put off visiting the doctor.

The burden of healthcare costs means that many consumers don’t get the care that they need. Across generations, nearly one in five people have delayed a doctor’s visit in the last three months because of cost. Among Gen Z, the portion is even greater, at 25%. Moreover, 22% of Gen Z individuals have skipped a recommended treatment or test for the same reason. Overall, 63% of these young consumers have made at least one change in their behavior due to healthcare costs, such as avoiding treatment, rationing medications, switching to more affordable providers or not filling their prescriptions.

Gen Z is also the most interested in new payment technologies that make paying for healthcare easier. Previous Generational Pulse research reveals that three in four of these consumers use digital healthcare tools. Additionally, the study also found that Gen Z individuals experience the most friction when making healthcare payments.

Whether because of the disproportionate financial burden they face or their existing comfort with technology, Gen Z consumers are 32% more likely than the population overall to express interest in at least one new technology.

Pricing transparency is a key concern. The most in-demand emerging feature across all generations is real-time insurance benefit checking tools. Nearly four in 10 Gen Z consumers would be interested, as would approximately one in three millennials. Additionally, 31% of Gen Z individuals would be interested in cost-prediction tools powered by artificial intelligence. Clearly, younger consumers want the ability to make smarter, more informed healthcare decisions powered by technology.

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Methodology

“Healthcare on Hold: Why 1 in 4 Gen Z Consumers Skip the Doctor” is based on a survey of 2,368 U.S. consumers conducted from Sept. 10, 2025, to Sept. 29, 2025. The report examines the financial challenges consumers face and the actions they are taking to address them. Population weights from the U.S. Census are used to ensure the analysis is representative of the U.S. adult population.