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Segment Information - Reconciliation of Gross Margin to Consolidated Income (Details) - USD ($) $ 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
Segment Reporting Information [Line Items]
Total margin	$ 664	$ 566	$ 673	$ 615	$ 446	$ 564	$ 254	$ 546	$ 2,518	$ 1,810	$ 1,725
Add: Other operating revenues	4,664	4,697	4,883	4,646	$ 4,949	$ 5,031	$ 4,999	$ 4,904	18,890	19,883	17,782
Less: Other operating expenses									(17,744)	(20,438)	(17,476)
Less: loss on sales of subsidiaries, net of gain	$ (52)	$ 37	$ 0	$ 0					(15)	0	0
Operating income (loss)									1,131	(555)	306
Less: other expenses, net									132	57	101
Income (loss) before income tax expense (benefit)									999	(612)	205
Health Plans
Segment Reporting Information [Line Items]
Add: Other operating revenues									18,471	19,352	17,234
Other
Segment Reporting Information [Line Items]
Total margin									43	29	54
Add: Other operating revenues									419	531	548
Operating Segments
Segment Reporting Information [Line Items]
Total margin									2,518	1,810	1,725
Operating Segments | Health Plans
Segment Reporting Information [Line Items]
Total margin									2,475	1,781	1,671
Operating Segments | Other
Segment Reporting Information [Line Items]
Total margin									43	29	54
Other Operating
Segment Reporting Information [Line Items]
Add: Other operating revenues									871	508	798
Less: Other operating expenses									(2,243)	(2,873)	(2,217)
Less: loss on sales of subsidiaries, net of gain									$ (15)	$ 0	$ 0

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Total costs of sales and operating expenses for the period.

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