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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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Total costs of sales and operating expenses for the period.

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