Healthcare Costs Force One in Four Gen Z to Skip Care

For younger Americans, healthcare spending is becoming less about treating illness and more about managing financial risk at a stage of life when cash flow is thin and costs are unpredictable.

That tension runs through “Economic Pressures Split the Generations as Each Rethinks the Basics,” the latest edition of the PYMNTS Intelligence “Generational Pulse,” series. Based on a September 2025 survey of 2,368 U.S. adults examining how rising medical costs are reshaping healthcare behavior across generations, the study finds that younger consumers, despite generally being healthier, experience a disproportionate financial burden from healthcare expenses. Insurance coverage does not insulate them from strain, as premiums, deductibles and out-of-pocket payments increasingly collide with early-career incomes, limited savings and fewer employer benefits.

The report shows healthcare costs intersect sharply with life stages. Gen Z and younger millennials are less likely to have chronic conditions, but they are more likely to pay directly when they seek care. Mental health services, dental visits and unexpected medical needs arrive at a moment when many are still building financial stability. Older consumers, by contrast, are more likely to have comprehensive coverage through Medicare or long-established employer plans, reducing their exposure even as they consume more care overall.

That imbalance helps explain why younger adults respond to rising costs by delaying or avoiding treatment rather than absorbing higher bills. Out-of-pocket payments are not occasional exceptions for these consumers. They are a routine part of accessing care, which turns even preventive visits into financial decisions.

Key data points from the report illustrate how deeply cost pressures are reshaping behavior:

80% of Gen Z consumers say healthcare costs place at least a moderate strain on their household budgets, nearly twice the share of baby boomers who report the same.

35% of Gen Z consumers paid at least part of the cost of their most recent healthcare visit out of pocket, compared with 14% of baby boomers and seniors.

25% of Gen Z consumers delayed a doctor’s visit in the past three months due to cost, and 22% skipped a recommended test or treatment for the same reason.

The report also highlights how insurance gaps amplify these pressures. Only 70% of Gen Z respondents say their most recent appointment was at least partially covered by insurance, compared with 86% of older adults. Nearly one-third of all consumers report insufficient coverage, suggesting that benefit design, not just access to insurance, is driving out-of-pocket exposure.

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

Other findings point to downstream effects for the payments and digital economy. Younger consumers show greater interest in tools that reduce uncertainty at the point of care, including real-time benefit checks and cost prediction technologies. They are also more likely to experience friction when paying medical bills, reinforcing demand for simpler, more transparent payment options. At the same time, the report notes that more than half of mental health visits now occur remotely, reflecting cost-conscious shifts toward lower-priced care channels that still leave patients paying directly.

Taken together, the findings suggest that healthcare affordability is no longer only about who needs care most. It is increasingly about when consumers encounter costs and how those costs align with income, savings and insurance design. For younger Americans, healthcare decisions are becoming a financial balancing act that extends well beyond the doctor’s office.