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Segment Information (Details) $ in Millions | 3 Months Ended | 12 Months Ended
--- | --- | ---
Dec. 31, 2018 USD ($) | Sep. 30, 2018 USD ($) | Jun. 30, 2018 USD ($) | Mar. 31, 2018 USD ($) | Dec. 31, 2017 USD ($) | Sep. 30, 2017 USD ($) | Jun. 30, 2017 USD ($) | Mar. 31, 2017 USD ($) | Dec. 31, 2018 USD ($) segment | Dec. 31, 2017 USD ($) | Dec. 31, 2016 USD ($)
Segment Reporting [Abstract] |  |  |  |  |  |  |  |  |  |  |
Number of Operating Segments | segment |  |  |  |  |  |  |  |  | 2 |  |
Revenues | $ 16,559 | $ 16,182 | $ 14,181 | $ 13,194 | $ 12,806 | $ 11,898 | $ 11,954 | $ 11,724 | $ 60,116 | $ 48,382 | $ 40,607
Earnings from operations |  |  |  |  |  |  |  |  | 1,458 | 1,199 | 1,263
Total assets | 30,901 |  |  |  | 21,855 |  |  |  | 30,901 | 21,855 | 20,197
Managed Care |  |  |  |  |  |  |  |  |  |  |
Revenues |  |  |  |  |  |  |  |  | 57,099 | 45,842 | 38,182
Earnings from operations |  |  |  |  |  |  |  |  | 1,310 | 917 | 1,080
Total assets | 27,627 |  |  |  | 19,959 |  |  |  | 27,627 | 19,959 | 18,423
Specialty Services |  |  |  |  |  |  |  |  |  |  |
Revenues |  |  |  |  |  |  |  |  | 12,506 | 12,055 | 2,425
Earnings from operations |  |  |  |  |  |  |  |  | 148 | 282 | 183
Total assets | $ 3,274 |  |  |  | $ 1,896 |  |  |  | 3,274 | 1,896 | 1,774
Operating Segments | Managed Care |  |  |  |  |  |  |  |  |  |  |
Revenues |  |  |  |  |  |  |  |  | 56,999 | 45,798 | 38,382
Operating Segments | Specialty Services |  |  |  |  |  |  |  |  |  |  |
Revenues |  |  |  |  |  |  |  |  | 3,117 | 2,584 | 8,377
Intersegment Eliminations |  |  |  |  |  |  |  |  |  |  |
Revenues |  |  |  |  |  |  |  |  | (9,489) | (9,515) | (6,152)
Intersegment Eliminations | Managed Care |  |  |  |  |  |  |  |  |  |  |
Revenues |  |  |  |  |  |  |  |  | 100 | 44 | 200
Intersegment Eliminations | Specialty Services |  |  |  |  |  |  |  |  |  |  |
Revenues |  |  |  |  |  |  |  |  | $ 9,389 | $ 9,471 | $ 5,952

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