Millennial patients know less about their health benefits, are less likely to pay their medical bills in full and often don’t save for medical expenses, according to a survey published by TransUnion Healthcare.

Of the 1,576 total respondents to the survey, 57 percent of the millennials (defineda as those born between 1980 and 1994) reported having limited or no understanding of what is covered by their health insurance, above the 50 percent of Generation Xers (born between 1965 and 1979) and 42 percent of baby boomers (born between 1946 and 1964) who said the same.

A higher percentage of millennials (26 percent) also reported not understanding increasing prevalent high-deductible health plans compared to 17 percent of Gen Xers and 9 percent of baby boomers.

“They came in a time when it was tough in healthcare,” Jonathan Wiik, principal of healthcare strategy at TransUnion, told HealthExec. “There was a lot of disruption going on, we were in a recession, high-deductible plans were just coming to bear, cost-shifting was going from employers to employees, and so they had to navigate all that. They really didn’t have a port to come from, they were thrown into the middle of the ocean, if you will, in terms of healthcare coverage chaos.

Like all age groups, most millennials aren’t paying their medical bills in full as more costs are shifted onto healthcare consumers. Millennials, however, are underpaying at a higher rate, with 74 percent reporting not paying their bills in full, compared to 68 percent for Gen Xers and 60 percent for baby boomers.

The typical response from practices or hospitals to outstanding bills would be send reminders in the mail ahead of forwarding the outstanding balance to collections. Wiik said this isn’t the right strategy for getting millennials—with less disposable income, short credit histories and fewer savings than older generations—to pay their bills more quickly.

“The traditional billing processes isn’t going to work,” Wiik said. “A millennial would find a bill in the mail coming in an envelope curious. That’s unfortunately how most hospitals typically bill.”

The problem isn’t about the desire to pay in full, as 70 percent of millennials said they would if they had the money to do so. To better support upfront payments, the TransUnion report recommended pre-service estimates and mobile payment options to simplify the financial conversations and help millennial clearly understand how much they have to pay and how they can make the payment.

“If hospitals can provide a mechanism to engage that patient early, that millennial, and really optimize that collection as early as they can, I think that’s key,” Wiik said. “That’s important for all patients, but specifically millennials, you’re going to have a more disruptive billing process downstream if they don’t do that.”