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Medical Claims and Benefits Payable - Components of the Change (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2018
Dec. 31, 2017
Dec. 31, 2016
Liability for Unpaid Claims and Claims Adjustment Expense [Roll Forward]      
Medical claims and benefits payable, beginning balance $ 2,192 $ 1,929 $ 1,685
Components of medical care costs related to:      
Current period 15,478 17,037 14,966
Prior periods (341) 36 (192)
Total medical care costs 15,137 17,073 14,774
Change in non-risk provider payables 13 (106) 58
Payments for medical care costs related to:      
Current period 13,671 15,130 13,304
Prior periods 1,710 1,574 1,284
Total paid 15,381 16,704 14,588
Medical claims and benefits payable, ending balance 1,961 $ 2,192 $ 1,929
CMS Subsidies      
Liability for Claims and Claims Adjustment Expense [Line Items]      
Disposal group, operating expense $ 81