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Segments - Reconciliation of Gross Margin to Consolidated Income (Details) - USD ($)
$ in Millions
 3 Months Ended 6 Months Ended
Jun. 30, 2025
Jun. 30, 2024
Jun. 30, 2025
Jun. 30, 2024
Revenue:        
Premium revenue $ 10,868 $ 9,446 $ 21,496 $ 18,950
Service revenue 22 20 44 40
Revenue from external customers 10,890 9,466 21,540 18,990
Other operating revenues 537 414 1,034 821
Total revenue 11,427 9,880 22,574 19,811
Operating expenses:        
Medical care costs 9,829 8,368 19,308 16,782
Cost of service revenue 19 18 38 36
Segment expenses 9,848 8,386 19,346 16,818
Other operating expenses 1,206 1,060 2,422 2,133
Operating income 373 434 806 860
Less: interest expense 48 28 91 55
Income before income tax expense 325 406 715 805
Medical margin        
Operating expenses:        
Segment margin 1,039 1,078 2,188 2,168
Service margin        
Operating expenses:        
Segment margin 3 2 6 4
Operating segments | Medicaid        
Revenue:        
Premium revenue 8,029 7,378 16,159 14,870
Service revenue 0 0 0 0
Revenue from external customers 8,029 7,378 16,159 14,870
Operating expenses:        
Medical care costs 7,332 6,695 14,671 13,412
Cost of service revenue 0 0 0 0
Segment expenses 7,332 6,695 14,671 13,412
Operating segments | Medicaid | Medical margin        
Operating expenses:        
Segment margin 697 683 1,488 1,458
Operating segments | Medicaid | Service margin        
Operating expenses:        
Segment margin 0 0 0 0
Operating segments | Medicare        
Revenue:        
Premium revenue 1,608 1,441 3,076 2,883
Service revenue 0 0 0 0
Revenue from external customers 1,608 1,441 3,076 2,883
Operating expenses:        
Medical care costs 1,447 1,224 2,743 2,503
Cost of service revenue 0 0 0 0
Segment expenses 1,447 1,224 2,743 2,503
Operating segments | Medicare | Medical margin        
Operating expenses:        
Segment margin 161 217 333 380
Operating segments | Medicare | Service margin        
Operating expenses:        
Segment margin 0 0 0 0
Operating segments | Marketplace        
Revenue:        
Premium revenue 1,200 627 2,204 1,197
Service revenue 0 0 0 0
Revenue from external customers 1,200 627 2,204 1,197
Operating expenses:        
Medical care costs 1,025 449 1,846 867
Cost of service revenue 0 0 0 0
Segment expenses 1,025 449 1,846 867
Operating segments | Marketplace | Medical margin        
Operating expenses:        
Segment margin 175 178 358 330
Operating segments | Marketplace | Service margin        
Operating expenses:        
Segment margin 0 0 0 0
Operating segments | Other        
Revenue:        
Premium revenue 31 0 57 0
Service revenue 22 20 44 40
Revenue from external customers 53 20 101 40
Operating expenses:        
Medical care costs 25 0 48 0
Cost of service revenue 19 18 38 36
Segment expenses 44 18 86 36
Operating segments | Other | Medical margin        
Operating expenses:        
Segment margin 6 0 9 0
Operating segments | Other | Service margin        
Operating expenses:        
Segment margin $ 3 $ 2 $ 6 $ 4