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Blue Cross and Blue Shield of Illinois fax number

(855) 867-6717

Medicare Supplement (ezBlue) ACH / Premium Payment

Used for: Submitting a Medicare Supplement ezBlue ACH payment form to authorize electronic debit for monthly premiums; includes fax submission to 855-867-6717 or mail to BCBSIL's address.

Fax destination details

Department
Medicare Supplement (ezBlue) ACH / Premium Payment
Purpose
Submitting a Medicare Supplement ezBlue ACH payment form to authorize electronic debit for monthly premiums; includes fax submission to 855-867-6717 or mail to BCBSIL's address.
Form
Medicare Supplement ACH / ezBlue Payment Form — Medicare Supplement ezBlue Payment Form
Address
Blue Cross and Blue Shield of Illinois, c/o Member Services, P.O. Box 3388, Scranton, PA 18505
Voice phone
877-384-9297

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Complete, sign, and return; if faxing, send to 855-867-6717; mail to Blue Cross and Blue Shield of Illinois, c/o Member Services, P.O. Box 3388, Scranton, PA 18505.

Official form instructions are published as a downloadable file on the organization's website.

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