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Segments - Reconciliation of Gross Margin to Consolidated Income (Details) - USD ($) $ in Millions | 3 Months Ended
--- | ---
Mar. 31, 2019 | Mar. 31, 2018
Segment Reporting Information [Line Items] |  |
Add: other operating revenues | $ 4,119 | $ 4,646
Less: other operating expenses | (3,839) | (4,424)
Operating income | 280 | 222
Other expenses, net | 20 | 43
Income before income tax expense | 260 | 179
Health Plans |  |
Segment Reporting Information [Line Items] |  |
Add: other operating revenues | 4,117 | 4,509
Other |  |
Segment Reporting Information [Line Items] |  |
Add: other operating revenues | 2 | 137
Operating Segments |  |
Segment Reporting Information [Line Items] |  |
Gross margin | 581 | 615
Operating Segments | Health Plans |  |
Segment Reporting Information [Line Items] |  |
Gross margin | 581 | 601
Operating Segments | Other |  |
Segment Reporting Information [Line Items] |  |
Gross margin | 0 | 14
Other operating |  |
Segment Reporting Information [Line Items] |  |
Add: other operating revenues | 167 | 189
Less: other operating expenses | $ (468) | $ (582)

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