Adults 65 and older use healthcare far more than any other age group. Despite making up only about 17% of the U.S. population, they account for roughly 37% of all personal health care spending. In 2020, per-person healthcare costs for this group averaged $22,356, nearly 2.5 times the $9,154 spent per working-age adult and more than five times the $4,217 spent per child. Most of these older adults are Baby Boomers and members of the Silent Generation. But the picture gets more nuanced when you look beyond total spending: younger generations are driving significant growth in mental health services and virtual care.
Spending by Age Group
Healthcare costs rise steeply with age. Per-person spending for adults over 85 reached $35,995 in 2020, more than 8.5 times the cost for children. Working-age adults (roughly 18 to 64) made up the largest share of both the population and total spending in absolute terms, simply because there are so many of them. But on a per-person basis, no group comes close to older adults.
Within the working-age population, women spend about 20% more on healthcare than men ($9,989 versus $8,313 per person in 2020), largely driven by reproductive health and higher rates of preventive care visits. That gap narrows significantly after 65, when men and women spend nearly the same amount.
Why Older Adults Need More Care
The primary driver is chronic disease. By 2009-2010, 45% of adults 65 and older had been diagnosed with two or more chronic conditions, compared with 21% of those aged 45 to 64. Conditions like heart disease, diabetes, arthritis, and high blood pressure require ongoing management, frequent doctor visits, lab work, and hospitalizations.
Prescription drug use follows the same pattern. The average number of prescriptions filled per year jumps from 13 for people aged 50 to 64 to 22 for those 80 and older. Each additional medication means more pharmacy costs, more monitoring appointments, and a higher chance of complications that send someone back to the doctor.
Preventive Care Visits Tell a Similar Story
Routine checkups and screenings are most common at the extremes of age. Adults 65 and older have the highest preventive care visit rate at 81.1 visits per 100 people, followed closely by children under 18 at 73.2 per 100. Working-age adults lag behind: only about 52 to 53 preventive visits per 100 people for those 18 to 64. That gap reflects both Medicare coverage (which eliminates many cost barriers for older adults) and the fact that younger, healthier adults often skip routine care when they feel fine.
Where Younger Generations Lead
Gen Z and Millennials are reshaping one corner of healthcare: mental health. About 27% of Gen Z adults report their mental health as fair or poor, compared with 15% of Millennials and 13% of Gen X. More importantly, younger generations are acting on it. Roughly 37% of Gen Z and 35% of Millennials have received treatment or therapy from a mental health professional. That drops to 26% for Gen X, 22% for Boomers, and just 15% for older adults. This isn’t necessarily because younger people have worse mental health than previous generations did at the same age. Greater openness about mental health and reduced stigma likely play a role in both self-reporting and treatment-seeking.
Younger generations also lead in telehealth adoption. Millennials have the highest virtual care utilization rate at 68%, followed by Gen Z at 60%. Boomers aged 65 to 74 aren’t far behind at 48%, and even 41% of the Silent Generation (75 and older) report using virtual care. Telehealth doesn’t necessarily mean more total healthcare use, but it does change how care gets delivered, making it easier for younger adults to access services they might otherwise skip.
The Baby Boomer Wave and Medicare
The most consequential trend in U.S. healthcare spending right now is the Baby Boomer generation aging into Medicare. By 2029, every Boomer will have reached Medicare eligibility, pushing enrollment to a projected 76 million beneficiaries, up from 66 million in 2023. Medicare spending is expected to nearly double between 2023 and 2032, reaching close to $2 trillion. That growth is driven by two forces: more beneficiaries entering the system (2 to 3% per year) and increasing volume and intensity of services per person (about 2.8% per year).
Medicare already consumes 3.8% of GDP and is projected to reach 4.9% by 2032. Meanwhile, the ratio of workers paying into the system for each beneficiary keeps shrinking. In 1967, there were 4.5 workers per Medicare beneficiary. By 2023, that had fallen to 2.8, and it’s expected to drop to 2.5 by 2029. Fewer workers supporting more beneficiaries creates a financing squeeze that will shape health policy debates for years.
The Full Picture
If you’re measuring by total dollars spent, hospital stays, prescriptions filled, or doctor visits, older generations (Baby Boomers and the Silent Generation) use healthcare the most by a wide margin. A single person over 65 consumes roughly as much healthcare as two or three working-age adults combined. Chronic conditions, prescription drug needs, and end-of-life care all concentrate spending in the later decades of life.
But healthcare use isn’t one-dimensional. Gen Z and Millennials are accessing mental health services at rates their parents and grandparents never did, and they’re more comfortable using technology to get care. As these younger cohorts age and develop their own chronic conditions, total spending will shift again. For now, though, the generation consuming the most healthcare is the one that’s been around the longest.