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Medical Claims and Benefits Payable - Components of Change in Medical Claims and Benefits Payable (Details) - USD ($)
$ in Millions
 3 Months Ended
Mar. 31, 2019
Mar. 31, 2018
Insurance Claims    
Medical claims and benefits payable, beginning balance $ 1,961 $ 2,192
Components of medical care costs related to:    
Current period 3,560 4,033
Prior periods (189) (311)
Total medical care costs 3,371 3,722
Change in non-risk provider payables 171 45
Payments for medical care costs related to:    
Current period 2,197 2,498
Prior periods 1,311 1,438
Total paid 3,508 3,936
Medical claims and benefits payable, ending balance $ 1,995 2,023
CMS Subsidies    
Liability for Claims and Claims Adjustment Expense [Line Items]    
Operating expense   $ 70