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Short-term and Long-term Investments, Restricted Deposits - Narrative (Details) - position
12 Months Ended
Dec. 31, 2018
May 31, 2018
Mar. 31, 2018
Schedule Of Investments And Restricted Deposits By Type [Line Items]      
Positions from which gross unrealized losses were generated 3,096    
Total number of positions 4,190    
RxAdvance      
Schedule Of Investments And Restricted Deposits By Type [Line Items]      
Equity method investment, ownership percentage   28.00% 25.00%
Commercial mortgage- backed securities      
Schedule Of Investments And Restricted Deposits By Type [Line Items]      
Investments that carry rating of A A plus, weighted average, duration 3 years 8 months    
External Credit Rating, Investment Grade | Rated Securities      
Schedule Of Investments And Restricted Deposits By Type [Line Items]      
Percentage of investment grade investments rated by nationally recognized statistical rating organizations 96.00%