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Segments - Reconciliation of Gross Margin to Consolidated Income (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Revenue:      
Premium revenue $ 38,627 $ 32,529 $ 30,883
Service revenue 81 76 71
Revenue from external customers 38,708 32,605 30,954
Other operating revenues 1,942 1,467 1,020
Total revenue 40,650 34,072 31,974
Operating Expenses:      
Medical care costs 34,428 28,669 27,175
Cost of service revenue 73 67 60
Segment expenses 34,501 28,736 27,235
Other operating expenses 4,442 3,763 3,566
Operating income 1,707 1,573 1,173
Interest expense 118 109 110
Less: interest expense 118 109 110
Income before income tax expense 1,589 1,464 1,063
Medical      
Operating Expenses:      
Medical margin 4,199 3,860 3,708
Service      
Operating Expenses:      
Medical margin 8 9 11
Operating Segments | Medicaid      
Revenue:      
Premium revenue 30,579 26,327 24,827
Service revenue 0 0 0
Revenue from external customers 30,579 26,327 24,827
Operating Expenses:      
Medical care costs 27,600 23,354 21,846
Cost of service revenue 0 0 0
Segment expenses 27,600 23,354 21,846
Operating Segments | Medicaid | Medical      
Operating Expenses:      
Medical margin 2,979 2,973 2,981
Operating Segments | Medicaid | Service      
Operating Expenses:      
Medical margin 0 0 0
Operating Segments | Medicare      
Revenue:      
Premium revenue 5,542 4,179 3,795
Service revenue 0 0 0
Revenue from external customers 5,542 4,179 3,795
Operating Expenses:      
Medical care costs 4,939 3,791 3,358
Cost of service revenue 0 0 0
Segment expenses 4,939 3,791 3,358
Operating Segments | Medicare | Medical      
Operating Expenses:      
Medical margin 603 388 437
Operating Segments | Medicare | Service      
Operating Expenses:      
Medical margin 0 0 0
Operating Segments | Marketplace      
Revenue:      
Premium revenue 2,506 2,023 2,261
Service revenue 0 0 0
Revenue from external customers 2,506 2,023 2,261
Operating Expenses:      
Medical care costs 1,889 1,524 1,971
Cost of service revenue 0 0 0
Segment expenses 1,889 1,524 1,971
Operating Segments | Marketplace | Medical      
Operating Expenses:      
Medical margin 617 499 290
Operating Segments | Marketplace | Service      
Operating Expenses:      
Medical margin 0 0 0
Operating Segments | Other      
Revenue:      
Premium revenue 0 0 0
Service revenue 81 76 71
Revenue from external customers 81 76 71
Operating Expenses:      
Medical care costs 0 0 0
Cost of service revenue 73 67 60
Segment expenses 73 67 60
Operating Segments | Other | Medical      
Operating Expenses:      
Medical margin 0 0 0
Operating Segments | Other | Service      
Operating Expenses:      
Medical margin $ 8 $ 9 $ 11