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Earnings Per Share (Details) - USD ($)
$ / shares in Units, $ in Millions
 3 Months Ended 12 Months Ended
Dec. 31, 2018
Sep. 30, 2018
Jun. 30, 2018
Mar. 31, 2018
Dec. 31, 2017
Sep. 30, 2017
Jun. 30, 2017
Mar. 31, 2017
Dec. 31, 2018
Dec. 31, 2017
Dec. 31, 2016
Earnings attributable to Centene Corporation:                      
Earnings attributable to Centene Corporation $ 241 $ 19 $ 300 $ 340 $ 230 $ 205 $ 254 $ 139 $ 900 $ 828 $ 562
Shares used in computing per share amounts:                      
Weighted average number of common shares outstanding (in shares)                 390,248,000 344,853,000 319,135,000
Common stock equivalents (as determined by applying the treasury stock method) (in shares)                 8,258,000 8,551,000 8,816,000
Weighted average number of common shares and potential dilutive common shares outstanding (in shares)                 398,506,000 353,404,000 327,951,000
Net earnings per common share attributable to Centene Corporation:                      
Basic earnings per common share (in usd per share) $ 0.59 $ 0.05 $ 0.77 $ 0.98 $ 0.67 $ 0.59 $ 0.74 $ 0.40 $ 2.31 $ 2.40 $ 1.76
Diluted earnings per common share (in usd per share) $ 0.57 $ 0.05 $ 0.75 $ 0.96 $ 0.65 $ 0.58 $ 0.72 $ 0.39 $ 2.26 $ 2.34 $ 1.71
Anti-dilutive stock options, restricted stock and restricted stock units excluded from the calculation of diluted earnings per common share (in shares)                 58,000 106,000 252,000