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Segments - Reconciliation of Gross Margin to Consolidated Income (Details) - USD ($)
$ in Millions
 3 Months Ended
Mar. 31, 2025
Mar. 31, 2024
Revenue:    
Premium revenue $ 10,628 $ 9,504
Service revenue 22 20
Revenue from external customers 10,650 9,524
Other operating revenues 497 407
Total revenue 11,147 9,931
Operating expenses:    
Medical care costs 9,479 8,414
Cost of service revenue 19 18
Segment expenses 9,498 8,432
Other operating expenses 1,216 1,073
Operating income 433 426
Less: interest expense 43 27
Income before income tax expense 390 399
Medical margin    
Operating expenses:    
Segment margin 1,149 1,090
Service margin    
Operating expenses:    
Segment margin 3 2
Operating segments | Medicaid    
Revenue:    
Premium revenue 8,130 7,492
Service revenue 0 0
Revenue from external customers 8,130 7,492
Operating expenses:    
Medical care costs 7,339 6,717
Cost of service revenue 0 0
Segment expenses 7,339 6,717
Operating segments | Medicaid | Medical margin    
Operating expenses:    
Segment margin 791 775
Operating segments | Medicaid | Service margin    
Operating expenses:    
Segment margin 0 0
Operating segments | Medicare    
Revenue:    
Premium revenue 1,468 1,442
Service revenue 0 0
Revenue from external customers 1,468 1,442
Operating expenses:    
Medical care costs 1,296 1,279
Cost of service revenue 0 0
Segment expenses 1,296 1,279
Operating segments | Medicare | Medical margin    
Operating expenses:    
Segment margin 172 163
Operating segments | Medicare | Service margin    
Operating expenses:    
Segment margin 0 0
Operating segments | Marketplace    
Revenue:    
Premium revenue 1,004 570
Service revenue 0 0
Revenue from external customers 1,004 570
Operating expenses:    
Medical care costs 821 418
Cost of service revenue 0 0
Segment expenses 821 418
Operating segments | Marketplace | Medical margin    
Operating expenses:    
Segment margin 183 152
Operating segments | Marketplace | Service margin    
Operating expenses:    
Segment margin 0 0
Operating segments | Other    
Revenue:    
Premium revenue 26 0
Service revenue 22 20
Revenue from external customers 48 20
Operating expenses:    
Medical care costs 23 0
Cost of service revenue 19 18
Segment expenses 42 18
Operating segments | Other | Medical margin    
Operating expenses:    
Segment margin 3 0
Operating segments | Other | Service margin    
Operating expenses:    
Segment margin $ 3 $ 2