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Medical Claims and Benefits Payable (Tables)

9 Months Ended

Sep. 30, 2024

Other Liabilities Disclosure [Abstract]

Schedule of Liability for Unpaid Claims and Claims Adjustment Expense

The following table provides the details of our medical claims and benefits payable as of the dates indicated:

			September 30, 2024						December 31, 2023
			(In millions)
Claims incurred but not paid (“IBNP”)			$	3,065					$	2,901
Pharmacy payable			249						202
Capitation payable			173						100
Other			1,245						1,001
Total			$	4,732					$	4,204

Schedule of Components of The Change in Medical Claims and Benefits Payable

The following tables present the components of the change in our medical claims and benefits payable for the periods indicated. The amounts presented for “Components of medical care costs related to: Prior years” represent the amount by which our original estimate of medical claims and benefits payable at the beginning of the year varied from the actual liabilities, based on information (principally the payment of claims) developed since those liabilities were first reported.

			Nine Months Ended September 30, 2024
			Medicaid						Medicare						Marketplace						Consolidated
			(In millions)
Medical claims and benefits payable, beginning balance			$	3,444					$	532					$	228					$	4,204
Components of medical care costs related to:
Current year			20,903						3,798						1,349						26,050
Prior years			(553)						(70)						(2)						(625)
Total medical care costs			20,350						3,728						1,347						25,425
Payments for medical care costs related to:
Current year			17,813						3,237						1,122						22,172
Prior years			2,256						742						217						3,215
Total paid			20,069						3,979						1,339						25,387
Acquired balances, net of post-acquisition adjustments			—						463						—						463
Change in non-risk and other payables			27						—						—						27
Medical claims and benefits payable, ending balance			$	3,752					$	744					$	236					$	4,732

			Nine Months Ended September 30, 2023
			Medicaid						Medicare						Marketplace						Consolidated
			(In millions)
Medical claims and benefits payable, beginning balance			$	2,815					$	452					$	261					$	3,528
Components of medical care costs related to:
Current year			17,630						2,811						1,132						21,573
Prior years			(327)						(6)						(25)						(358)
Total medical care costs			17,303						2,805						1,107						21,215
Payments for medical care costs related to:
Current year			14,961						2,340						927						18,228
Prior years			2,074						424						209						2,707
Total paid			17,035						2,764						1,136						20,935
Acquired balances, net of post-acquisition adjustments			83						13						—						96
Change in non-risk and other provider payables			335						(4)						—						331
Medical claims and benefits payable, ending balance			$	3,501					$	502					$	232					$	4,235

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Components Of Change In Medical Claims And Benefits Payable [Table Text Block]

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- Definition

Tabular disclosure of the activity in the reserve for settling insured claims and expenses incurred in the claims settlement process for the period. The estimated liability includes the amount of money that will be required for future payments of (a) claims that have been reported to the insurer, (b) claims related to insured events that have occurred but that have not been reported to the insurer as of the date the liability is estimated, and (c) claim adjustment expenses. Claim adjustment expenses include costs incurred in the claim settlement process such as legal fees; outside adjuster fees; and costs to record, process, and adjust claims.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 944
-SubTopic 40
-Name Accounting Standards Codification
-Section 50
-Paragraph 3
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480081/944-40-50-3

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