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Quarterly Selected Financial Information (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
Quarterly Financial Information Disclosure [Abstract]                      
Total revenues $ 16,559 $ 16,182 $ 14,181 $ 13,194 $ 12,806 $ 11,898 $ 11,954 $ 11,724 $ 60,116 $ 48,382 $ 40,607
Net earnings $ 241 $ 19 $ 300 $ 340 $ 230 $ 205 $ 254 $ 139 $ 900 $ 828 $ 562
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