In the context of digital transformation, smart senior care (SSC) cognition among elderly individuals has become an important contributor to their health. Using a sample of 345 older adults derived from the cross-sectional data of a questionnaire survey on the application of home-based SSC services and products among elderly individuals, this study explored how the parent‒child relationship mediated the linkage between SSC cognition and elderly health. To examine the moderating role of internet use, we applied the multigroup structural equation modeling (SEM) approach to test whether significant disparities exist between older adults who use the internet and those who do not on the pathways in the mediation model. After controlling for gender, age, (household registration permit), ethnicity, income, marital status, and education level, we found that SSC cognition exerted significant positive effects on elderly health, in which the parent‒child relationship exerted a mediating effect. As for differences between the elderly with internet use and those without, on the three pathways connecting SSC cognition and health, SSC cognition and parent‒child relationship, and parent‒child relationship and health among elderly individuals, older adults who used the internet were more susceptible than those who did not. The findings are helpful for improving the policy-making on elderly health and may serve as a practical guide and theoretical reference for the promotion of active aging.