v3.26.3
Segment Information
 9 Months Ended
Sep. 30, 2026
Segment Reporting [Abstract]  
Segment Information Segment Information
The Company operates in four segments: (1) a Medicaid segment, (2) a Medicare segment, (3) a Commercial segment and (4) an Other segment. The Medicaid, Medicare and Commercial segments primarily represent the government-sponsored or subsidized programs under which the Company offers managed healthcare services. The Other segment includes the Company's pharmacy operations, vision and dental services, clinical healthcare, behavioral health, and corporate management company, among others.

Factors used in determining the reportable business segments include the nature of operating activities, the existence of separate senior management teams and the type of information presented to the Company's chief operating decision-maker (CODM) to evaluate all results of operations. The Company's CODM is its Chief Executive Officer. The Company's CODM focuses primarily on each segment's ability to generate sufficient revenues and manage expenses associated with health benefits and cost of services (including estimated costs incurred). As such, the CODM measures operating performance at the segment level based on gross margin, including evaluation of budget to actual variances, to determine the allocation of financial and capital resources for each segment. The Company does not report total assets by segment since this is not a metric used by the Company's CODM to allocate resources or evaluate segment performance.

Segment information for the three months ended September 30, 2026, is as follows ($ in millions):
MedicaidMedicareCommercialOther/EliminationsConsolidated Total
Premium$24,004 $11,263 $8,699 $404 $44,370 
Service35 — 1 699 735 
Premium and service revenues24,039 11,263 8,700 1,103 45,105 
Premium tax5,542 — — — 5,542 
Total external revenues29,581 11,263 8,700 1,103 50,647 
Internal revenues— — — 3,749 3,749 
Eliminations— — — (3,749)(3,749)
Total revenues$29,581 $11,263 $8,700 $1,103 $50,647 
Medical costs$22,476 $10,564 $7,742 $346 $41,128 
Cost of services35 — — 640 675 
Other operating expenses (1)
9,151 
Other income (expense) (2)
185 
(Loss) before income tax$(122)
Segment gross margin (3)
$1,528 $699 $958 $117 $3,302 
(1)
Other operating expenses include selling, general and administrative expenses, depreciation, amortization, premium tax expense and impairment.
(2)
Other income (expense) includes investment and other income, debt extinguishment and interest expense.
(3)
Segment gross margin represents premium and service revenues less medical costs and cost of services.
Segment information for the three months ended September 30, 2025, is as follows ($ in millions):
MedicaidMedicareCommercialOther/EliminationsConsolidated Total
Premium$23,146 $9,391 $10,991 $598 $44,126 
Service25 — 1 746 772 
Premium and service revenues23,171 9,391 10,992 1,344 44,898 
Premium tax4,792 — — — 4,792 
Total external revenues27,963 9,391 10,992 1,344 49,690 
Internal revenues— — — 4,194 4,194 
Eliminations— — — (4,194)(4,194)
Total revenues$27,963 $9,391 $10,992 $1,344 $49,690 
Medical costs$21,614 $8,853 $9,876 $559 $40,902 
Cost of services25 — — 626 651 
Other operating expenses (1)
15,091 
Other income (expense) (2)
280 
(Loss) before income tax$(6,674)
Segment gross margin (3)
$1,532 $538 $1,116 $159 $3,345 
(1)
Other operating expenses include selling, general and administrative expenses, depreciation, amortization, premium tax expense and impairment.
(2)
Other income (expense) includes investment and other income, debt extinguishment and interest expense.
(3)
Segment gross margin represents premium and service revenues less medical costs and cost of services.
Segment information for the nine months ended September 30, 2026, is as follows ($ in millions):
MedicaidMedicareCommercialOther/EliminationsConsolidated Total
Premium$70,322 $32,646 $27,609 $1,262 $131,839 
Service79 — 3 2,214 2,296 
Premium and service revenues70,401 32,646 27,612 3,476 134,135 
Premium tax20,035 — — — 20,035 
Total external revenues90,436 32,646 27,612 3,476 154,170 
Internal revenues— — — 11,994 11,994 
Eliminations— — — (11,994)(11,994)
Total revenues$90,436 $32,646 $27,612 $3,476 $154,170 
Medical costs$65,788 $29,228 $22,349 $1,095 $118,460 
Cost of services79 — — 2,027 2,106 
Other operating expenses (1)
30,852 
Other income (expense) (2)
711 
Earnings before income tax$3,463 
Segment gross margin (3)
$4,534 $3,418 $5,263 $354 $13,569 
(1)
Other operating expenses include selling, general and administrative expenses, depreciation, amortization, premium tax expense and impairment.
(2)
Other income (expense) includes investment and other income, debt extinguishment and interest expense.
(3)
Segment gross margin represents premium and service revenues less medical costs and cost of services.
Segment information for the nine months ended September 30, 2025, is as follows ($ in millions):
MedicaidMedicareCommercialOther/EliminationsConsolidated Total
Premium$67,118 $27,600 $31,209 $1,651 $127,578 
Service75 — 2 2,199 2,276 
Premium and service revenues67,193 27,600 31,211 3,850 129,854 
Premium tax15,198 — — — 15,198 
Total external revenues82,391 27,600 31,211 3,850 145,052 
Internal revenues— — — 12,325 12,325 
Eliminations— — — (12,325)(12,325)
Total revenues$82,391 $27,600 $31,211 $3,850 $145,052 
Medical costs$63,038 $24,995 $26,607 $1,573 $116,213 
Cost of services74 — — 1,916 1,990 
Other operating expenses (1)
32,727 
Other income (expense) (2)
693 
(Loss) before income tax$(5,185)
Segment gross margin (3)
$4,081 $2,605 $4,604 $361 $11,651 
(1)
Other operating expenses include selling, general and administrative expenses, depreciation, amortization, premium tax expense and impairment.
(2)
Other income (expense) includes investment and other income, debt extinguishment and interest expense.
(3)
Segment gross margin represents premium and service revenues less medical costs and cost of services.