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Significant Accounting Policies - Consolidated Medical Care Costs (Details) - USD ($) | 12 Months Ended
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Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016
Medical Care Costs |  |  |
Fee-for-service | $ 11,278,000,000 | $ 12,682,000,000 | $ 10,993,000,000
Pharmacy | 2,138,000,000 | 2,563,000,000 | 2,213,000,000
Capitation | 1,184,000,000 | 1,360,000,000 | 1,218,000,000
Other | 537,000,000 | 468,000,000 | 350,000,000
Total | 15,137,000,000 | 17,073,000,000 | 14,774,000,000
Medical Care Costs, PMPM |  |  |
Fee-for-service (per member per month) | 232.15 | 229.63 | 217.84
Pharmacy (per member per month) | 44.01 | 46.40 | 43.84
Capitation (per member per month) | 24.38 | 24.63 | 24.13
Other (per member per month) | 11.05 | 8.48 | 6.94
Total (per member per month) | $ 311.59 | $ 309.14 | $ 292.75
Medical Care Costs, Percentage |  |  |
Percentage of total in Fee for service | 74.50% | 74.30% | 74.40%
Percentage of total in pharmacy | 14.10% | 15.00% | 15.00%
Percentage of total in capitation | 7.80% | 8.00% | 8.20%
Percentage of total in other | 3.60% | 2.70% | 2.40%
Percentage of total | 100.00% | 100.00% | 100.00%

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