Frequently Asked Questions
Answers to the most common questions

Pivotal Health can treat nearly every non-life-threatening medical condition that can be treated in an urgent care center or other health care facility. This includes a wide range of common to complex illnesses and injuries, such as respiratory infections, sore throats, rashes, urinary tract infections (UTIs), fall injuries, lacerations that require stitches, and more. Pivotal Health providers can treat patients of all ages – from infants to the elderly.

Pivotal Health can treat nearly every non-life-threatening medical condition that can be treated in an urgent care center or other health care facility. This includes a wide range of common to complex illnesses and injuries, such as respiratory infections, urinary tract infections (UTIs), fall injuries, migraines, dehydration, lacerations that require stitches, and more. Pivotal Health providers can treat patients of all ages – from infants to the elderly.

Here is a partial list of conditions and situations that Pivotal Health may treat by telehealth:

• Many skin conditions such as acne, rashes, cellulitis, dermatitis, diaper rash, etc.
• Bacterial Vaginosis
• Some UTIs and yeast infections
• Erectile Dysfunction
• Birth Control
• Pink eye
• Anxiety
• Depression

If you need a specialist, Pivotal Health can make a referral to specialists at any health system or clinic. We’ve made referrals for our patients for most specialties including orthopedics, dermatology, gastroenterology, neurology, psychiatry, and more.

From September through May, Pivotal Health is open Monday to Friday from 8 am to 8 pm and on Saturday and Sunday from 10 am to 7 pm. From June through August, Pivotal Health is open Monday to Friday from 8 am to 5 pm and on Saturday and Sunday from 10 am to 5 pm.

In the Madison area, Pivotal Health serves all of Dane County and Lodi, Sauk City, and Prairie du Sac. At the University of Wisconsin-Madison, Pivotal Health can go into all dormitories and apartment buildings in the Madison area. In northeast Wisconsin, the service area includes Brown, Outagamie, Winnebago, Green Lake, Calumet, and Fond du Lac counties. Pivotal Health also serves part of Kewaunee and Dodge counties.

You can schedule a visit with the Pivotal Health mobile app or by calling us at 888-688-4746. The mobile app, available for Apple and Android phones, is a quick and easy way to tell us what symptoms you’re experiencing, select a time that works for you, and pay your out-of-pocket cost (if you have one). We also automatically send the after-visit summary directly to the app after the visit.

When you schedule a visit, you select the time. We typically see patients on the same day, but it may be the next morning if you try to schedule in the late afternoon or evening. Our Direct Care members have a guarantee to be seen within 24 hours for urgent care issues.

As of August 1, 2024, Pivotal Health no longer accepts health insurance except for The Alliance and HPS. Pivotal Health has a low-cost membership option called Pivotal Health Direct Care (see below) and has a menu of affordable self-pay prices for single visits or select services.

Yes. If you are not a Pivotal Health member, a single visit will cost $189. This must be paid when scheduling the visit through the mobile app or when you call.

No. While you can pay for an individual visit with your Health Savings Account (HSA) or Flexible Spending Account (FSA) plan, current law does not allow you to pay for a healthcare membership with those plans. There are various bills in Congress and state legislatures that may change that, but those have not yet been signed into law.

Pivotal Health offers a healthcare solution directly to employers. Employers can pay a low monthly fee per employee and then their employees and family members can schedule urgent care, primary care, or occupational health visits for $0 to $50 according to the Employer’s preference.

This is an excellent way for employers to control their rapidly rising healthcare costs while giving their employees the benefit of low-cost, high-quality, ultra-convenient healthcare. And it can help significantly reduce future health insurance rate increases because there are no insurance claims associated with this service.

No. Pivotal Health Direct Care is not an insurance plan; you’ll still need insurance if you have a major health problem. Pivotal Health strongly recommends that our members have a high-deductible or catastrophic health insurance plan.