Health Care Costs Payable - Narrative (Details) $ in Billions	Dec. 31, 2018 USD ($)
Health Care Benefits
Health Care And Other Insurance Liabilities [Line Items]
Short-duration Insurance Contracts, Incurred but Not Reported (IBNR) Claims Liability, Net	$ 4.1

Undiscounted amount, after reinsurance, of incurred-but-not-reported (IBNR) liabilities plus expected development on reported claims, for claims and allocated claim adjustment expense for short-duration insurance contracts. Excludes unallocated claim adjustment expense.

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 944
-SubTopic 40
-Section 50
-Paragraph 4E
-URI http://asc.fasb.org/extlink&oid=116884468&loc=SL65671321-158438

Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 944
-SubTopic 40
-Section 50
-Paragraph 4D
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=116884468&loc=SL65671317-158438

Name:	us-gaap_ShortdurationInsuranceContractsIncurredButNotReportedIbnrClaimsLiabilityNet
Namespace Prefix:	us-gaap_
Data Type:	xbrli:monetaryItemType
Balance Type:	credit
Period Type:	instant