Background The objective of the study was to indicate social and psychological (inner) motives associated with the desire and needs of travelling to health resorts (push) as well as external motives resulting from destination’s attributes, and explaining the choice of the health tourism establishment (pull) by Polish treatment‑seekers divided into two social groups: persons in employment and retired persons. The research hypothesis assumed the two groups of people differ very much in terms of preferences motivating them to participate in health resort tourism, destination choices and services offered by health resort establishments. Methods Of the 258 health resorts, 154 establishments were selected for research purposes taking into account a proportional distribution of health resorts throughout Poland. An authorial questionnaire was developed and it included three questions with multiple answers, each answer being assessed on a 5‑point Likert scale. The research adds new insights by analysing motives associated with health resort tourism in terms of benefits sought by visitors. The main and strongest motive for choosing health resort tourism is concern for health. In addition to old age pen‑ sioners, it was legitimate to analyse the group of employed respondents as their stays at a health resort are under‑ taken to regain not only physical fitness but also work motivation. Results The present study has demonstrated that motives and age groups have a significant effect on destination choice. Based on the results, it can be concluded that these groups often have diverse needs, expectations and, as a result, motives for choosing this form of tourism and a given health resort. What follows is a possibility of dividing the visitors to health resorts in terms of push and pull motives. Conclusions The research hypothesis assuming the two groups varied considerably in terms of preferences motivat‑ ing them to participate in health resort tourism, destination selection and choice of services offered by the health resort establishment has been confirmed. The ramifications of the study’s findings may also be relevant for health resort/spa tourism outside of Poland because healthy lifestyle promotion is a worldwide trend. Keywords Motivation, Health tourism, Destination choice, Additional services, Tourism