www.medicare.gov Open in urlscan Pro
2a02:26f0:7100:1a9::348  Public Scan

Submitted URL: http://appemail.boehringer-ingelheim.com/c/eJx9TstugzAQ_Bq4xbLBYDj4QEoqRe2lVVv16scarBqwDAn9_Jq0Qjl1tRqtdmd2RvOaVLJILc9wRgiJwGhBSkRrqYgxJc...
Effective URL: https://www.medicare.gov/
Submission: On November 03 via api from US — Scanned from DE

Form analysis 3 forms found in the DOM

GET /search/medicare

<form action="/search/medicare" method="get" id="search-block-form" accept-charset="UTF-8" role="search" class="search-form search-block-form" aria-hidden="true">
  <div class="js-form-item form-item js-form-type-search form-type-search js-form-item-keys form-item-keys form-no-label">
    <label for="edit-keys" class="m-evo-label ds-c-label visually-hidden"><span>Search</span></label>
    <input title="Enter the terms you wish to search for." placeholder="Search Medicare" aria-label="Search Medicare" class="sl-search-input form-search" data-drupal-selector="edit-keys" type="search" id="edit-keys" name="keys" value="" size="15"
      maxlength="128">
  </div>
  <div data-drupal-selector="edit-actions" class="form-actions js-form-wrapper form-wrapper" id="edit-actions--2">
    <input class="search-form__submit button js-form-submit form-submit ds-c-button ds-c-button--primary" data-drupal-selector="edit-submit" type="submit" id="edit-submit" value="Search">
  </div>
</form>

<form novalidate="">
  <input name="e" type="email" required="" id="prefix-emailInput" aria-labelledby="prefix-overlay-label" placeholder="">
  <div id="prefix-consent-outer">
    <input name="consent" type="checkbox" id="prefix-consentPolicyInput"> <label for="prefix-consentPolicyInput" id="prefix-consentPolicyLabel">By checking this box, you consent to our
      <a href="https://www.medicare.gov/privacy-policy" target="_blank" rel="noopener noreferrer">data privacy policy</a>.</label>
  </div>
  <input type="submit" value="Next Step" id="prefix-submitButton">
</form>

<form id="prefix-formStepForm" novalidate="">
  <label for="q_74299" style="text-transform: uppercase;">Please tell us which best describes you</label>
  <div id="prefix-questions"><select name="q_74299" class="prefix-questionId" id="prefix-q_74299" disabled="">
      <option value="228746">I currently have Medicare</option>
      <option value="228747">I will have Medicare soon (in less than 3 years) </option>
      <option value="228748">I am a caregiver for someone who has Medicare</option>
      <option value="228749">Other </option>
    </select></div>
  <label for="q_65497" style="text-transform: uppercase;">Select your state</label>
  <div id="prefix-questions"><select name="q_65497" id="prefix-q_65497" class="prefix-questionId" disabled="">
      <option value="" selected="" disabled="">Select your state</option>
      <option value="193817">Alabama</option>
      <option value="193818">Alaska</option>
      <option value="193819">Arizona</option>
      <option value="193820">Arkansas</option>
      <option value="193821">California</option>
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      <option value="193823">Connecticut</option>
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      <option value="193827">Georgia</option>
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      <option value="193829">Idaho</option>
      <option value="193830">Illinois</option>
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      <option value="193832">Iowa</option>
      <option value="193833">Kansas</option>
      <option value="193834">Kentucky</option>
      <option value="193835">Louisiana</option>
      <option value="193836">Maine</option>
      <option value="193837">Maryland</option>
      <option value="193838">Massachusetts</option>
      <option value="193839">Michigan</option>
      <option value="193840">Minnesota</option>
      <option value="193841">Mississippi</option>
      <option value="193842">Missouri</option>
      <option value="193843">Montana</option>
      <option value="193844">Nebraska</option>
      <option value="193845">Nevada</option>
      <option value="193846">New Hampshire</option>
      <option value="193847">New Jersey</option>
      <option value="193848">New Mexico</option>
      <option value="193849">New York</option>
      <option value="193850">North Carolina</option>
      <option value="193851">North Dakota</option>
      <option value="193852">Ohio</option>
      <option value="193853">Oklahoma</option>
      <option value="193854">Oregon</option>
      <option value="193855">Pennsylvania</option>
      <option value="193856">Rhode Island</option>
      <option value="193857">South Carolina</option>
      <option value="193858">South Dakota</option>
      <option value="193859">Tennessee</option>
      <option value="193860">Texas</option>
      <option value="193861">Utah</option>
      <option value="193862">Vermont</option>
      <option value="193863">Virginia</option>
      <option value="193864">Washington</option>
      <option value="193865">West Virginia</option>
      <option value="193866">Wisconsin</option>
      <option value="193867">Wyoming</option>
      <option value="193868">Puerto Rico</option>
      <option value="193869">U.S. Virgin Islands</option>
      <option value="193870">American Samoa</option>
      <option value="193871">Guam</option>
      <option value="193872">Northern Mariana Islands</option>
      <option value="239669">Other</option>
    </select></div>
  <input type="submit" value="Continue" id="prefix-formStep-submitButton">
</form>

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