paymentportal.bcbsil.com
Open in
urlscan Pro
205.172.134.131
Public Scan
URL:
https://paymentportal.bcbsil.com/
Submission: On September 26 via automatic, source certstream-suspicious — Scanned from DE
Submission: On September 26 via automatic, source certstream-suspicious — Scanned from DE
Form analysis 1 forms found in the DOM
<form class="fiber_form_03147559" data-di-form-track="" data-di-form-id="Retail Payment IL One Time">
<div class="sc-iNiQyp gkrluc">
<div class="sc-laZMeE bxdeDI"><span class="fiber_text_a15f07de fiber_text_Size2_a15f07de fiber_text_ColorBlack_a15f07de fiber_text_WeightBold_a15f07de fiber_text_StyleNormal_a15f07de fiber_taLeft_fb140e05"
data-testid="memberIdLengthLabelError">Member ID Number (9 Digits)</span><button class="fiber_iconButton_a842c970" type="button" data-di-id="di-id-6c22b328-81e3c002"><span
class="fiber_icon_a9f74e41 fiber_icon_SizeInherit_a9f74e41 fiber_icon_ColorBlack_a9f74e41"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 24 24" xml:space="preserve" fill="currentColor" role="img" aria-hidden="true" focusable="false"
data-di-res-id="1a528d42-325f1380" data-di-rand="1695765329002">
<path d="M12 2C6.5 2 2 6.5 2 12s4.5 10 10 10 10-4.5 10-10S17.5 2 12 2zm0 18.5c-4.7 0-8.5-3.8-8.5-8.5S7.3 3.5 12 3.5s8.5 3.8 8.5 8.5-3.8 8.5-8.5 8.5z"></path>
<path d="M13 9.5H9.2V11h2.3v5.5H9.2V18h6v-1.5H13z"></path>
<ellipse cx="12.3" cy="7.2" rx="0.9" ry="1"></ellipse>
</svg></span><span class="fiber_iconButton__srOnly_a842c970">information</span></button></div>
<div class="sc-fbIWvP nUeYk"><img class="sc-lbVvki iTDLpd" alt="Member ID Card Icon" id="Image_6" data-testid="member-id-information-icon" src="https://bam-aem.hcsc.net/content/dam/hcsc/guest-payment-portal/images/member-id-icon.svg">
<div class="sc-gGLxEB fOQikK"><span data-testid="member-input-placeholder-A" class="sc-FRrlG gULlBG">A</span><span data-testid="member-input-placeholder-B" class="sc-FRrlG gULlBG">B</span><span data-testid="member-input-placeholder-C"
class="sc-FRrlG gULlBG">C</span></div>
<div class="sc-eirqVv jJNMji"><span class="fiber_input_c26a2848"><input class="sc-ckTSus hzoERL" placeholder="" inputmode="numeric" maxlength="9" minlength="9" data-testid="memberIdInput" value=""></span></div>
</div>
</div>
<div class="sc-gSYDnn NepQQ">
<div class="fiber_form__field_03147559"><label for="FormField_1" class="fiber_label_30e4676d" id="FormField_1_Label"><span
class="fiber_text_a15f07de fiber_text_Size2_a15f07de fiber_text_ColorTextDark_a15f07de fiber_text_WeightBold_a15f07de fiber_text_StyleNormal_a15f07de fiber_taLeft_fb140e05">Date of Birth</span></label><span
class="fiber_input_c26a2848"><input class="fiber_input__input_c26a2848" name="date-of-birth" data-testid="date-of-birth-input" type="text" placeholder="MM / YYYY" maxlength="9" inputmode="numeric" id="FormField_1"
aria-labelledby="FormField_1_Label" value="" data-di-id="#FormField_1"></span></div>
</div>
<div class="fiber_form__field_03147559"><label for="FormField_2" class="fiber_label_30e4676d" id="FormField_2_Label"><span
class="fiber_text_a15f07de fiber_text_Size2_a15f07de fiber_text_ColorTextDark_a15f07de fiber_text_WeightBold_a15f07de fiber_text_StyleNormal_a15f07de fiber_taLeft_fb140e05">Billing ZIP Code</span></label><span
class="fiber_input_c26a2848"><input class="fiber_input__input_c26a2848" name="zip-code" data-testid="zip-code-input" maxlength="5" inputmode="numeric" id="FormField_2" aria-labelledby="FormField_2_Label" value=""
data-di-id="#FormField_2"></span></div><label class="fiber_checkbox_ded49b71"><input type="checkbox" data-testid="acceptTerms"><span class="fiber_checkbox__label_ded49b71 fiber_checkbox__label_Left_ded49b71"><span
class="fiber_text_a15f07de fiber_text_Size2_a15f07de fiber_text_ColorTextDark_a15f07de fiber_text_WeightNormal_a15f07de fiber_text_StyleNormal_a15f07de fiber_taLeft_fb140e05 fiber_mt0_fb140e05 fiber_mb0_fb140e05 fiber_mr3_fb140e05 fiber_ml3_fb140e05"><a class="fiber_text_a15f07de fiber_text_Size2_a15f07de fiber_text_ColorTextDark_a15f07de fiber_text_WeightNormal_a15f07de fiber_text_StyleNormal_a15f07de fiber_taLeft_fb140e05" data-testid="acceptTermsText" data-di-id="di-id-46693797-cef0e41b">I understand and accept the </a><span
class="sc-hhIiOg iwisNA"><a class="fiber_text_a15f07de fiber_text_Size2_a15f07de fiber_text_ColorBluePrimary_a15f07de fiber_text_WeightNormal_a15f07de fiber_text_StyleNormal_a15f07de fiber_taLeft_fb140e05" data-testid="acceptTermsLink" data-di-id="di-id-f1bd603b-f3453844">Terms of Use and Privacy Statement.</a></span></span></span></label>
<div class="sc-jffHpj jCxXAC"><button class="fiber_button_8d86c930 fiber_button_Size2_8d86c930 fiber_button_Primary_8d86c930 fiber_button_Block_8d86c930" disabled="" type="submit" data-testid="continue-form"
data-di-id="di-id-736bd15f-8ad9e4cd"><span class="fiber_button__text_8d86c930">Continue</span></button></div>
</form>Text Content
You need to enable JavaScript to run this app. Español Language Assistance Exit Make A One-Time Payment For the best experience, please be sure your browser is up to date. Have a Member Account? Log In -------------------------------------------------------------------------------- To pay as a guest, fill out the policy holder's information below. Member ID Number (9 Digits)information ABC Date of Birth Billing ZIP Code I understand and accept the Terms of Use and Privacy Statement. Continue Legal & Privacy | Non-Discrimination Notice Blue Cross and Blue Shield of Illinois, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association © Copyright 2022 Health Care Service Corporation. All Rights Reserved. Feedback