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Medical Claims and Benefits Payable - Components of the Change (Details) - USD ($) $ in Millions | 12 Months Ended
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Dec. 31, 2023 | Dec. 31, 2022 | Dec. 31, 2021
Liability for Unpaid Claims and Claims Adjustment Expense [Roll Forward] |  |  |
Medical claims and benefits payable, beginning balance | $ 3,528 | $ 3,363 | $ 2,696
Components of medical care costs related to: |  |  |
Current year | 29,096 | 27,459 | 23,943
Prior years | (427) | (284) | (239)
Incurred Claims and Allocated Claims Adjustment Expenses | 28,669 | 27,175 | 23,704
Payments for medical care costs related to: |  |  |
Current year | 25,615 | 24,345 | 21,148
Prior years | 2,734 | 2,670 | 2,080
Total paid | 28,349 | 27,015 | 23,228
Acquired balances, net of post-acquisition adjustments | 96 | 12 | 197
Change in non-risk and other provider payables | 260 | (7) | (6)
Medical claims and benefits payable, ending balance | 4,204 | 3,528 | 3,363
Medicaid |  |  |
Liability for Unpaid Claims and Claims Adjustment Expense [Roll Forward] |  |  |
Medical claims and benefits payable, beginning balance | 2,815 | 2,580 | 2,129
Components of medical care costs related to: |  |  |
Current year | 23,749 | 22,097 | 18,321
Prior years | (395) | (251) | (182)
Incurred Claims and Allocated Claims Adjustment Expenses | 23,354 | 21,846 | 18,139
Payments for medical care costs related to: |  |  |
Current year | 20,999 | 19,655 | 16,284
Prior years | 2,069 | 1,966 | 1,601
Total paid | 23,068 | 21,621 | 17,885
Acquired balances, net of post-acquisition adjustments | 82 | 12 | 205
Change in non-risk and other provider payables | 261 | (2) | (8)
Medical claims and benefits payable, ending balance | 3,444 | 2,815 | 2,580
Medicare |  |  |
Liability for Unpaid Claims and Claims Adjustment Expense [Roll Forward] |  |  |
Medical claims and benefits payable, beginning balance | 452 | 404 | 392
Components of medical care costs related to: |  |  |
Current year | 3,802 | 3,390 | 2,970
Prior years | (11) | (32) | (39)
Incurred Claims and Allocated Claims Adjustment Expenses | 3,791 | 3,358 | 2,931
Payments for medical care costs related to: |  |  |
Current year | 3,293 | 2,944 | 2,573
Prior years | 431 | 361 | 340
Total paid | 3,724 | 3,305 | 2,913
Acquired balances, net of post-acquisition adjustments | 14 | 0 | (8)
Change in non-risk and other provider payables | (1) | (5) | 2
Medical claims and benefits payable, ending balance | 532 | 452 | 404
Marketplace |  |  |
Liability for Unpaid Claims and Claims Adjustment Expense [Roll Forward] |  |  |
Medical claims and benefits payable, beginning balance | 261 | 379 | 175
Components of medical care costs related to: |  |  |
Current year | 1,545 | 1,972 | 2,652
Prior years | (21) | (1) | (18)
Incurred Claims and Allocated Claims Adjustment Expenses | 1,524 | 1,971 | 2,634
Payments for medical care costs related to: |  |  |
Current year | 1,323 | 1,746 | 2,291
Prior years | 234 | 343 | 139
Total paid | 1,557 | 2,089 | 2,430
Acquired balances, net of post-acquisition adjustments | 0 | 0 | 0
Change in non-risk and other provider payables | 0 | 0 | 0
Medical claims and benefits payable, ending balance | $ 228 | $ 261 | $ 379

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- Definition The amount needed to reflect the estimated ultimate cost of settling claims relating to insured events that have occurred on or before the balance sheet date, whether or not reported to the insurer at that date. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Topic 944 -SubTopic 40 -Name Accounting Standards Codification -Section 50 -Paragraph 3 -Subparagraph (cc) -Publisher FASB -URI https://asc.fasb.org//1943274/2147480081/944-40-50-3 Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef -Name Accounting Standards Codification -Topic 944 -SubTopic 40 -Section 50 -Paragraph 3 -Subparagraph (a) -Publisher FASB -URI https://asc.fasb.org//1943274/2147480081/944-40-50-3 + Details
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