v3.26.3
Segments - Reconciliation of Gross Margin to Consolidated Income (Details) - USD ($)
$ in Millions
 3 Months Ended 9 Months Ended
Sep. 30, 2026
Sep. 30, 2025
Sep. 30, 2026
Sep. 30, 2025
Revenue:        
Premium revenue $ 10,457 $ 10,841 $ 30,873 $ 32,337
Service revenue 23 21 69 65
Revenue from external customers 10,480 10,862 30,942 32,402
Other operating revenues 602 615 1,810 1,649
Total revenue 11,082 11,477 32,752 34,051
Operating expenses:        
Medical care costs 9,719 10,044 28,429 29,352
Cost of service revenue 21 20 64 58
Segment expenses 9,740 10,064 28,493 29,410
Other operating expenses 1,236 1,276 3,925 3,698
Operating income 106 137 334 943
Less: interest expense 53 49 161 140
Income before income tax expense 53 88 173 803
Medical margin        
Operating expenses:        
Segment margin 738 797 2,444 2,985
Service margin        
Operating expenses:        
Segment margin 2 1 5 7
Operating segments | Medicaid        
Revenue:        
Premium revenue 8,199 8,015 24,175 24,174
Service revenue 0 0 0 0
Revenue from external customers 8,199 8,015 24,175 24,174
Operating expenses:        
Medical care costs 7,622 7,376 22,382 22,047
Cost of service revenue 0 0 0 0
Segment expenses 7,622 7,376 22,382 22,047
Operating segments | Medicaid | Medical margin        
Operating expenses:        
Segment margin 577 639 1,793 2,127
Operating segments | Medicaid | Service margin        
Operating expenses:        
Segment margin 0 0 0 0
Operating segments | Medicare        
Revenue:        
Premium revenue 1,616 1,610 4,698 4,686
Service revenue 0 0 0 0
Revenue from external customers 1,616 1,610 4,698 4,686
Operating expenses:        
Medical care costs 1,503 1,507 4,285 4,250
Cost of service revenue 0 0 0 0
Segment expenses 1,503 1,507 4,285 4,250
Operating segments | Medicare | Medical margin        
Operating expenses:        
Segment margin 113 103 413 436
Operating segments | Medicare | Service margin        
Operating expenses:        
Segment margin 0 0 0 0
Operating segments | Marketplace        
Revenue:        
Premium revenue 642 1,197 1,994 3,401
Service revenue 0 0 0 0
Revenue from external customers 642 1,197 1,994 3,401
Operating expenses:        
Medical care costs 594 1,144 1,761 2,990
Cost of service revenue 0 0 0 0
Segment expenses 594 1,144 1,761 2,990
Operating segments | Marketplace | Medical margin        
Operating expenses:        
Segment margin 48 53 233 411
Operating segments | Marketplace | Service margin        
Operating expenses:        
Segment margin 0 0 0 0
Operating segments | Other        
Revenue:        
Premium revenue 0 19 6 76
Service revenue 23 21 69 65
Revenue from external customers 23 40 75 141
Operating expenses:        
Medical care costs 0 17 1 65
Cost of service revenue 21 20 64 58
Segment expenses 21 37 65 123
Operating segments | Other | Medical margin        
Operating expenses:        
Segment margin 0 2 5 11
Operating segments | Other | Service margin        
Operating expenses:        
Segment margin $ 2 $ 1 $ 5 $ 7