Centene (CNC) 10-K 18 Feb 25 2024 FY Annual report Financial data

Cover

Cover - USD ($) shares in Thousands, $ in Billions	12 Months Ended
	Dec. 31, 2024	Feb. 14, 2025	Jun. 30, 2024
Cover [Abstract]
Document Type	10-K
Document Annual Report	true
Document Period End Date	Dec. 31, 2024
Current Fiscal Year End Date	--12-31
Document Transition Report	false
Entity File Number	001-31826
Entity Registrant Name	Centene Corporation
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	42-1406317
Entity Address, Address Line One	7700 Forsyth Boulevard
Entity Address, City or Town	St. Louis,
Entity Address, State or Province	MO
Entity Address, Postal Zip Code	63105
City Area Code	314
Local Phone Number	725-4477
Title of 12(b) Security	Common Stock, $0.001 Par Value
Trading Symbol	CNC
Security Exchange Name	NYSE
Entity Well-known Seasoned Issuer	Yes
Entity Voluntary Filers	No
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
ICFR Auditor Attestation Flag	true
Document Financial Statement Error Correction [Flag]	false
Entity Shell Company	false
Public Float			$ 34.9
Entity Common Stock, Shares Outstanding		496,044
Documents Incorporated by Reference	Portions of the Proxy Statement for the registrant's 2025 annual meeting of stockholders are incorporated by reference in Part III, Items 10, 11, 12, 13 and 14.
Entity Central Index Key	0001071739
Document Fiscal Year Focus	2024
Document Fiscal Period Focus	FY
Amendment Flag	false

Audit Information

Audit Information	12 Months Ended
	Dec. 31, 2024
Auditor Information [Abstract]
Auditor Name	KPMG LLP
Auditor Location	St. Louis, MO
Auditor Firm ID	185

CONSOLIDATED BALANCE SHEETS

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Millions	Dec. 31, 2024	Dec. 31, 2023
Current assets:
Cash and cash equivalents	$ 14,063	$ 17,193
Premium and trade receivables	19,713	15,532
Short-term investments	2,622	2,459
Other current assets	1,601	5,572
Total current assets	37,999	40,756
Long-term investments	17,429	16,286
Restricted deposits	1,390	1,386
Property, software and equipment, net	2,067	2,019
Goodwill	17,558	17,558
Intangible assets, net	5,409	6,101
Other long-term assets	593	535
Total assets	82,445	84,641
Current liabilities:
Medical claims liability	18,308	18,000
Accounts payable and accrued expenses	13,174	16,420
Return of premium payable	2,008	1,462
Unearned revenue	661	715
Current portion of long-term debt	110	119
Total current liabilities	34,261	36,716
Long-term debt	18,423	17,710
Deferred tax liability	684	641
Other long-term liabilities	2,567	3,618
Total liabilities	55,935	58,685
Commitments and contingencies
Redeemable noncontrolling interests	10	19
Stockholders' equity:
Preferred stock, $0.001 par value; authorized 10,000 shares; no shares issued or outstanding at December 31, 2024 and December 31, 2023	0	0
Common stock, $0.001 par value; authorized 800,000 shares; 620,195 issued and 495,907 outstanding at December 31, 2024, and 615,291 issued and 534,484 outstanding at December 31, 2023	1	1
Additional paid-in capital	20,562	20,304
Accumulated other comprehensive (loss)	(504)	(652)
Retained earnings	15,348	12,043
Treasury stock, at cost (124,288 and 80,807 shares, respectively)	8,997	5,856
Total Centene stockholders' equity	26,410	25,840
Nonredeemable noncontrolling interest	90	97
Total stockholders' equity	26,500	25,937
Total liabilities, redeemable noncontrolling interests and stockholders' equity	$ 82,445	$ 84,641

CONSOLIDATED BALANCE SHEETS (Pa

CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares shares in Thousands	Dec. 31, 2024	Dec. 31, 2023
Stockholders' equity:
Preferred stock, par value (in usd per share)	$ 0.001	$ 0.001
Preferred stock, shares authorized (in shares)	10,000	10,000
Preferred stock, shares issued (in shares)	0	0
Preferred stock, shares outstanding (in shares)	0	0
Common stock, par value (in usd per share)	$ 0.001	$ 0.001
Common stock, shares authorized (in shares)	800,000	800,000
Common stock, shares issued (in shares)	620,195	615,291
Common stock, shares outstanding (in shares)	495,907	534,484
Treasury stock, at cost (in shares)	124,288	80,807

CONSOLIDATED STATEMENTS OF OPER

CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) shares in Thousands, $ in Millions	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Revenues:
Revenues	$ 145,505	$ 140,095	$ 135,479
Premium tax	17,566	13,904	9,068
Total revenues	163,071	153,999	144,547
Expenses:
Medical costs	125,707	118,894	111,529
Cost of services	2,729	3,564	7,032
Selling, general and administrative expenses	12,400	12,563	11,589
Depreciation expense	549	575	614
Amortization of acquired intangible assets	692	718	817
Premium tax expense	17,806	14,226	9,330
Impairment	13	529	2,318
Total operating expenses	159,896	151,069	143,229
Earnings from operations	3,175	2,930	1,318
Other income (expense):
Investment and other income	1,784	1,393	1,279
Debt extinguishment	0	0	30
Interest expense	(702)	(725)	(665)
Earnings before income tax	4,257	3,598	1,962
Income tax expense	963	899	760
Net earnings	3,294	2,699	1,202
Loss attributable to noncontrolling interests	11	3	0
Net earnings attributable to Centene Corporation	$ 3,305	$ 2,702	$ 1,202
Net earnings per common share attributable to Centene Corporation:
Basic earnings per common share (in usd per share)	$ 6.33	$ 4.97	$ 2.09
Diluted earnings per common share (in usd per share)	$ 6.31	$ 4.95	$ 2.07
Weighted average number of common shares outstanding:
Basic (in shares)	521,790	543,319	575,191
Diluted (in shares)	523,744	545,704	582,040
Premium
Revenues:
Revenues	$ 142,303	$ 135,636	$ 127,131
Service
Revenues:
Revenues	$ 3,202	$ 4,459	$ 8,348

CONSOLIDATED STATEMENTS OF COMP

CONSOLIDATED STATEMENTS OF COMPREHENSIVE EARNINGS (LOSS) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Statement of Comprehensive Income [Abstract]
Net earnings	$ 3,294	$ 2,699	$ 1,202
Change in unrealized gain (loss) on investments	94	520	(1,475)
Change in unrealized gain (loss) on investments, tax effect	(29)	(128)	349
Change in unrealized gain (loss) on investments, net of tax	65	392	(1,126)
Reclassification adjustment, net of tax	83	62	11
Foreign currency translation adjustments, net of tax	0	36	(94)
Net unrealized (loss) on cash flow hedge, net of tax	0	(10)	0
Other comprehensive earnings (loss)	148	480	(1,209)
Comprehensive earnings (loss)	3,442	3,179	(7)
Comprehensive loss attributable to noncontrolling interests	11	3	0
Comprehensive earnings (loss) attributable to Centene Corporation	$ 3,453	$ 3,182	$ (7)

CONSOLIDATED STATEMENTS OF STOC

CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY - USD ($) shares in Thousands, $ in Millions	Total	Common Stock	Additional Paid-in Capital	Accumulated Other Comprehensive Earnings (Loss)	Retained Earnings	Treasury Stock	Noncontrolling Interest
Beginning balance (in shares) at Dec. 31, 2021		602,704
Beginning balance at Dec. 31, 2021	$ 26,940	$ 1	$ 19,672	$ 77	$ 8,139	$ (1,094)	$ 145
Beginning balance, Treasury stock (in shares) at Dec. 31, 2021						20,225
Increase (Decrease) in Stockholders' Equity
Net earnings (loss)	1,189				1,202		(13)
Other comprehensive (loss) earnings, net of tax	(1,209)			(1,209)
Common stock issued for employee benefit plans (in shares)		5,143
Common stock issued for employee benefit plans	71		71
Fair value of unvested equity awards in connection with acquisition	60		60
Common stock repurchases (in shares)						(36,868)
Common stock repurchases	(3,096)		23			$ (3,119)
Stock compensation expense	234		234
Reclassification to non-redeemable	17						17
Divestiture of noncontrolling interest	(14)						(14)
Dividend to noncontrolling interest	(10)						(10)
Purchase of non-redeemable noncontrolling interest	(1)						(1)
Ending balance (in shares) at Dec. 31, 2022		607,847
Ending balance at Dec. 31, 2022	24,181	$ 1	20,060	(1,132)	9,341	$ (4,213)	124
Ending balance, Treasury stock (in shares) at Dec. 31, 2022						57,093
Increase (Decrease) in Stockholders' Equity
Net earnings (loss)	2,699				2,702		(3)
Other comprehensive (loss) earnings, net of tax	480			480
Common stock issued for employee benefit plans (in shares)		7,444
Common stock issued for employee benefit plans	44		44
Common stock repurchases (in shares)						(23,714)
Common stock repurchases	(1,643)					$ (1,643)
Stock compensation expense	216		216
Purchase of redeemable noncontrolling interest	(12)		(12)
Purchase of non-redeemable noncontrolling interest	$ (28)		(4)				(24)
Ending balance (in shares) at Dec. 31, 2023	534,484	615,291
Ending balance at Dec. 31, 2023	$ 25,937	$ 1	20,304	(652)	12,043	$ (5,856)	97
Ending balance, Treasury stock (in shares) at Dec. 31, 2023	80,807					80,807
Increase (Decrease) in Stockholders' Equity
Net earnings (loss)	$ 3,300				3,305		(5)
Other comprehensive (loss) earnings, net of tax	148			148
Common stock issued for employee benefit plans (in shares)		4,904
Common stock issued for employee benefit plans	46		46
Common stock repurchases (in shares)						(43,481)
Common stock repurchases	(3,141)					$ (3,141)
Stock compensation expense	212		212
Divestiture of noncontrolling interest	$ (2)						(2)
Ending balance (in shares) at Dec. 31, 2024	495,907	620,195
Ending balance at Dec. 31, 2024	$ 26,500	$ 1	$ 20,562	$ (504)	$ 15,348	$ (8,997)	$ 90
Ending balance, Treasury stock (in shares) at Dec. 31, 2024	124,288					124,288

CONSOLIDATED STATEMENTS OF ST_2

CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY (Parenthetical) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Common stock, par value (in usd per share)	$ 0.001	$ 0.001
Other comprehensive (loss) earnings, tax	$ 31	$ 144	$ (349)
Common Stock
Common stock, par value (in usd per share)	$ 0.001	$ 0.001	$ 0.001	$ 0.001
Treasury Stock
Common stock, par value (in usd per share)	$ 0.001	$ 0.001	$ 0.001	$ 0.001

CONSOLIDATED STATEMENTS OF CASH

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Cash flows from operating activities:
Net earnings	$ 3,294	$ 2,699	$ 1,202
Adjustments to reconcile net earnings to net cash provided by operating activities
Depreciation and amortization	1,241	1,293	1,430
Stock compensation expense	212	216	234
Impairment	13	529	2,318
(Gain) loss on debt extinguishment	0	0	(25)
(Gain) on acquisition	0	0	(2)
Deferred income taxes	13	(78)	(631)
(Gain) loss on divestitures, net	(120)	(152)	(772)
Loss on disposal of equipment	0	0	221
Other adjustments, net	16	172	(31)
Changes in assets and liabilities
Premium and trade receivables	(4,333)	(2,380)	(1,627)
Other assets	46	5	128
Medical claims liabilities	368	1,261	2,397
Unearned revenue	(54)	238	31
Accounts payable and accrued expenses	(528)	3,398	421
Other long-term liabilities	(70)	856	842
Other operating activities, net	56	(4)	125
Net cash provided by operating activities	154	8,053	6,261
Cash flows from investing activities:
Capital expenditures	(644)	(799)	(1,004)
Purchases of investments	(7,183)	(6,622)	(6,736)
Sales and maturities of investments	5,785	5,523	3,802
Acquisitions, net of cash acquired	0	0	(1,460)
Divestiture proceeds, net of divested cash	990	707	2,477
Net cash used in investing activities	(1,052)	(1,191)	(2,921)
Cash flows from financing activities:
Proceeds from long-term debt	1,300	2,335	360
Payments and repurchases of long-term debt	(622)	(2,316)	(1,490)
Common stock repurchases	(3,124)	(1,633)	(3,096)
Proceeds from common stock issuances	46	44	70
Payments for debt extinguishment	0	0	(14)
Purchase of noncontrolling interest	0	(88)	0
Other financing activities, net	(6)	0	(27)
Net cash used in financing activities	(2,406)	(1,658)	(4,197)
Effect of exchange rate changes on cash, cash equivalents and restricted cash	8	(32)	(11)
Net increase (decrease) in cash, cash equivalents and restricted cash and cash equivalents	(3,296)	5,172	(868)
Cash and cash equivalents reclassified (to) from held for sale	0	(50)	(16)
Cash, cash equivalents and restricted cash and cash equivalents, beginning of period	17,452	12,330	13,214
Cash, cash equivalents and restricted cash and cash equivalents, end of period	14,156	17,452	12,330
Supplemental disclosures of cash flow information:
Interest paid	688	688	657
Income taxes paid, net	1,002	887	1,198
Equity issued in connection with acquisitions	0	0	60
The following table provides a reconciliation of cash, cash equivalents and restricted cash and cash equivalents reported within the Consolidated Balance Sheets to the totals above:
Cash and cash equivalents	14,063	17,193	12,074
Restricted cash and cash equivalents, included in restricted deposits	93	259	256
Total cash, cash equivalents, and restricted cash and cash equivalents	$ 14,156	$ 17,452	$ 12,330

Organization and Operations

Organization and Operations	12 Months Ended
	Dec. 31, 2024
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Organization and Operations	Organization and Operations Centene Corporation, or the Company, is a leading provider of government-sponsored healthcare. Centene's focus is on improving health and health care for low-income populations with complex needs. The Company provides access to high-quality healthcare, innovative programs and a wide range of health solutions that help families and individuals get well, stay well and be well. 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. Specifically, the Medicaid segment includes the Temporary Assistance for Needy Families (TANF) program, Medicaid Expansion programs, the Aged, Blind or Disabled (ABD) program, the Children's Health Insurance Program (CHIP), Long-Term Services and Supports (LTSS), Foster Care, Medicare-Medicaid Plans (MMP), which cover beneficiaries who are dually eligible for Medicaid and Medicare and other state-based programs. The Medicare segment includes Medicare Advantage, Medicare Supplement, Dual Eligible Special Needs Plans (D-SNPs) and Medicare Prescription Drug Plans (PDPs), also known as Medicare Part D. The Commercial segment includes the Health Insurance Marketplace product along with individual, small group and large group commercial health insurance products. The Other segment includes the Company's pharmacy operations, Envolve Benefit Options' vision and dental services, clinical healthcare, behavioral health, international operations and corporate management company, among others. The Company's international businesses, Operose Health Group (Operose Health) and Circle Health Group (Circle Health), which were included in the Other segment, were divested in December 2023 and January 2024, respectively.

Summary of Significant Accounti

Summary of Significant Accounting Policies	12 Months Ended
	Dec. 31, 2024
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	Summary of Significant Accounting Policies Basis of Presentation The accompanying consolidated financial statements include the accounts of Centene Corporation and all majority owned subsidiaries and subsidiaries over which the Company exercises the power and control to direct activities significantly impacting financial performance. All material intercompany balances and transactions have been eliminated. Certain 2022 and 2023 amounts in the consolidated financial statements and notes to the consolidated financial statements have been reclassified to conform to the 2024 presentation. These reclassifications have no effect on net earnings or stockholders' equity as previously reported. During 2024, the Company completed the divestitures of Circle Health and Collaborative Health Systems (CHS). See Note 3. Acquisitions and Divestitures for further details. Use of Estimates The preparation of financial statements in conformity with generally accepted accounting principles in the United States (GAAP) requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, the disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Future events and their effects cannot be predicted with certainty; accordingly, the accounting estimates require the exercise of judgment. The accounting estimates used in the preparation of the consolidated financial statements will change as new events occur, as more experience is acquired, as additional information is obtained, and as the operating environment changes. The Company evaluates and updates its assumptions and estimates on an ongoing basis and may employ outside experts to assist in its evaluation, as considered necessary. Actual results could differ from those estimates. Business Combinations Business combinations are accounted for using the acquisition method of accounting. The Company allocates the fair value of purchase consideration to the assets acquired and liabilities assumed based on their fair values at the acquisition date. The excess of the fair value of consideration transferred over the fair value of the net assets acquired is recorded as goodwill. Goodwill is generally attributable to the value of the synergies between the combined companies and the value of the acquired assembled workforce, neither of which qualifies for recognition as an intangible asset. The Company uses its best estimates and assumptions to value assets acquired and liabilities assumed at the acquisition date; however, these estimates are sometimes preliminary and, in some instances, all information required to value the assets acquired and liabilities assumed may not be available or final as of the end of a reporting period subsequent to the business combination. If the accounting for the business combination is incomplete, provisional amounts are recorded. The provisional amounts are updated during the period determined, up to one year from the acquisition date. The Company includes the results of operations of acquired businesses in the Company's consolidated results prospectively from the date of acquisition. Acquisition related expenses and post-acquisition restructuring costs are recognized separately from the business combination and are expensed as incurred. Cash and Cash Equivalents Investments with original maturities of three months or less are considered to be cash equivalents. Cash equivalents consist of money market funds, bank certificates of deposit and savings accounts. The Company maintains amounts on deposit with various financial institutions, which may exceed federally insured limits. However, management periodically evaluates the credit-worthiness of those institutions, and the Company has not experienced any losses on such deposits. Investments Short-term investments include securities with maturities greater than three months to one year. Long-term investments include securities with maturities greater than one year. Short-term and long-term investments are generally classified as available-for-sale and are carried at fair value. Certain equity investments are recorded using the fair value or equity method. The Company monitors the difference between the carrying value and fair value of its available-for-sale debt investments and whether declines in fair value are credit related. Unrealized gains and losses on debt investments available-for-sale are excluded from earnings and reported in accumulated other comprehensive earnings (loss), a separate component of stockholders' equity, net of income tax effects. If a loss is deemed to be credit related, the Company recognizes an allowance through earnings. For each security in an unrealized loss position, the Company assesses whether it intends to sell the security or if it is more likely than not the Company will be required to sell the security before recovery of the amortized cost basis for reasons such as liquidity, contractual or regulatory purposes. If the security meets this criterion, the decline in fair value is recorded in earnings through investment and other income. Premiums and discounts are amortized or accreted over the life of the related security using the effective interest method. To calculate realized gains and losses on the sale of investments, the Company uses the specific amortized cost of each investment sold. Realized gains and losses are recorded in investment and other income. The Company uses the equity method to account for investments in entities that it does not control but has the ability to exercise significant influence over operating and financial policies. Generally, under the equity method, original investments in these entities are recorded at cost and subsequently adjusted by the Company's share of equity in income or losses after the date of acquisition as well as capital contributions to and distributions from these companies. Restricted Deposits Restricted deposits consist of investments required by various state statutes to be deposited or pledged to state agencies. These investments are classified as long-term, regardless of the contractual maturity date, due to the nature of the states' requirements. The Company is required to annually adjust the amount of the deposit pledged to certain states. Fair Value Measurements In the normal course of business, the Company invests in various financial assets and incurs various financial liabilities. Fair values are disclosed for all financial instruments, whether or not such values are recognized in the Consolidated Balance Sheets. Management obtains quoted market prices and other observable inputs for these disclosures. The carrying amounts reported in the Consolidated Balance Sheets for cash and cash equivalents, premium and trade receivables, medical claims liability, accounts payable and accrued expenses, unearned revenue and certain other current assets and liabilities are carried at cost, which approximates fair value because of their short-term nature. The following methods and assumptions were used to estimate the fair value of each financial instrument: • Available-for-sale investments and restricted deposits: The carrying amount is stated at fair value, based on quoted market prices, where available. For securities not actively traded, fair values were estimated using values obtained from independent pricing services or quoted market prices of comparable instruments. • Senior unsecured notes: Estimated based on third-party quoted market prices for the same or similar issues. • Variable rate debt: The carrying amount of the Company's floating rate debt approximates fair value since the interest rates adjust based on market rate adjustments. • Contingent consideration: Estimated based on expected achievement of metrics included in the acquisition agreement considering circumstances that exist as of the acquisition date. Property, Software and Equipment Property, software and equipment are stated at cost less accumulated depreciation. Computer hardware and software includes certain costs incurred in the development of internal-use software, including external direct costs of materials and services and payroll costs of team members devoted to specific software development. Depreciation is calculated principally by the straight-line method over estimated useful lives. Leasehold improvements are depreciated using the straight-line method over the shorter of the expected useful life or the remaining term of the lease. Property, software and equipment are depreciated over the following periods: Fixed Asset Depreciation Period Buildings and improvements 10 - 40 years Computer hardware and software 3 - 5 years Furniture and equipment 5 - 10 years Land improvements 10 - 25 years Leasehold improvements 1 - 20 years The carrying amounts of all long-lived assets are evaluated to determine if adjustment to the depreciation and amortization period or to the unamortized balance is warranted. Such evaluation is based principally on the expected utilization of the long-lived assets. The Company retains fully depreciated assets in property and accumulated depreciation accounts until it removes them from service. In the case of sale, retirement or disposal, the asset cost and related accumulated depreciation balance is removed from the respective account, and the resulting net amount, less any proceeds, is included as a component of earnings from operations in the Consolidated Statements of Operations. Goodwill and Intangible Assets Intangible assets represent assets acquired in purchase transactions and consist primarily of purchased contract rights and customer relationships, provider contracts, trade names, developed technologies and goodwill. Intangible assets are amortized using the straight-line method over the following periods: Intangible Asset Amortization Period Purchased contract rights and customer relationships 3 - 21 years Provider contracts 4 - 15 years Trade names 7 - 20 years Developed technologies 2 - 7 years The Company tests for impairment of intangible assets, as well as long-lived assets, whenever events or circumstances indicate that the carrying value of an asset or asset group (hereinafter referred to as "asset group") may not be recoverable by comparing the sum of the estimated undiscounted future cash flows expected to result from use of the asset group and its eventual disposition to the carrying value. Such factors include significant changes in membership, financial performance, state funding, government contracts and provider networks and contracts. If the sum of the estimated undiscounted future cash flows is less than the carrying value, an impairment determination is required. The amount of impairment is calculated by subtracting the fair value of the asset group from the carrying value of the asset group. An impairment charge, if any, is recognized within earnings from operations. The Company operates in four segments: (1) a Medicaid segment, (2) a Medicare segment, (3) a Commercial segment and (4) an Other segment. The Company defines its reporting units as its operating segments or one level below the operating segment. The Company tests goodwill for impairment at the reporting unit level using a fair value approach. The Company is required to test for impairment at least annually, absent a triggering event, which could include a significant decline in operating performance that would require an impairment assessment. Absent any impairment indicators, the Company performs its goodwill impairment testing during the fourth quarter of each year. The Company recognizes an impairment charge for any amount by which the carrying amount of goodwill exceeds its fair value. The Company first assesses qualitative factors to determine whether it is necessary to perform the quantitative goodwill impairment test. The Company generally does not calculate the fair value of a reporting unit unless it determines, based on a qualitative assessment, that it is more likely than not that its fair value is less than its carrying amount. If the quantitative test is deemed necessary, the Company determines an appropriate valuation technique to estimate a reporting unit's fair value as of the testing date. The Company utilizes either the income approach or the market approach, whichever is most appropriate for the respective reporting unit. The income approach is based on an internally developed discounted cash flow model that includes assumptions related to future growth rates, discount factors, future tax rates and other various assumptions. The market approach is based on financial multiples of comparable companies derived from current market data. The Company then compares the fair value of the reporting unit calculated using the income approach or market approach with its carrying amount and recognizes an impairment charge for the amount by which the carrying amount exceeds fair value. The impairment charge is limited to the total amount of goodwill allocated to the reporting unit. Changes in economic and operating conditions impacting assumptions used in the Company's analyses could result in goodwill impairment in future periods. Medical Claims Liability Medical claims liability includes claims reported but not yet paid, or claims inventory, estimates for claims incurred but not reported, or IBNR, and estimates for the costs necessary to process unpaid claims at the end of each period. The Company estimates its medical claims liability using actuarial methods that are commonly used by health insurance actuaries and meet Actuarial Standards of Practice. These actuarial methods consider factors such as historical data for payment patterns, cost trends, product mix, seasonality, utilization of healthcare services and other relevant factors. Actuarial Standards of Practice generally require that the medical claims liability estimates be adequate to cover obligations under moderately adverse conditions. Moderately adverse conditions are situations in which the actual claims are expected to be higher than the otherwise estimated value of such claims at the time of estimate. The claims amounts ultimately settled will most likely be different than the estimate that satisfies the Actuarial Standards of Practice. The Company includes in its IBNR an estimate for medical claims liability under moderately adverse conditions which represents the risk of adverse deviation of the estimates in its actuarial method of reserving. The Company uses its judgment to determine the assumptions to be used in the calculation of the required estimates. The assumptions it considers when estimating IBNR include, without limitation, claims receipt and payment experience (and variations in that experience), changes in membership, provider billing practices, healthcare service utilization trends, cost trends, product mix, seasonality, prior authorization of medical services, benefit changes, known outbreaks of disease or increased incidence of illness such as influenza, provider contract changes, changes to fee schedules and the incidence of high-dollar or catastrophic claims. The Company's development of the medical claims liability estimate is a continuous process which it monitors and refines on a monthly basis as additional claims receipts and payment information becomes available. As more complete claims information becomes available, the Company adjusts the amount of the estimates, and includes the changes in estimates in medical costs in the period in which the changes are identified. In every reporting period, the operating results include the effects of more completely developed medical claims liability estimates associated with previously reported periods. The Company consistently applies its reserving methodology from period to period. As additional information becomes known, it adjusts the actuarial models accordingly to establish medical claims liability estimates. The Company reviews actual and anticipated experience compared to the assumptions used to establish medical costs. The Company establishes premium deficiency reserves if actual and anticipated experience indicates that existing policy liabilities together with the present value of future gross premiums will not be sufficient to cover the present value of future benefits, settlement and maintenance costs. For purposes of determining premium deficiencies, contracts are grouped in a manner consistent with the method of acquiring, servicing and measuring the profitability of such contracts and expected investment income is excluded. In December 2023, the Company recorded a premium deficiency reserve of $250 million related to the 2024 Medicare Advantage contract year. In December 2024, the Company recorded a premium deficiency reserve of $92 million related to the 2025 Medicare Advantage contract year. Revenue Recognition The Company's health plans generate revenues primarily from premiums received from the states in which it operates health plans, premiums received from its members and the Centers for Medicare and Medicaid Services (CMS) for its Medicare product and premiums from members of its commercial health plans. In addition to member premium payments, its Marketplace contracts also generate revenues from subsidies received from CMS. The Company generally receives a fixed premium per member per month pursuant to its contracts and recognizes premium revenues during the period in which it is obligated to provide services to its members at the amount reasonably estimable. In some instances, the Company's base premiums are subject to an adjustment, in the form of a risk score or risk adjustment, based on the acuity of its membership. Generally, the risk score or risk adjustment is determined by the state or CMS analyzing submissions of processed claims and medical record data to determine the acuity of the Company's membership, often relative to the respective program's membership. The Company estimates the amount of risk score and risk adjustment based upon the processed claims and medical record data submitted and expected to be submitted to the state or CMS and records revenues on a risk adjusted basis. Some contracts allow for additional premiums related to certain supplemental services provided such as maternity deliveries. The Company's contracts with states and CMS may require it to maintain a minimum medical loss ratio (MLR) or may require it to share cost-savings in excess of certain levels. In certain circumstances, including commercial plans, its plans may be required to return premium to the state or policyholders in the event costs are below established levels. The Company estimates the effect of these programs and recognizes reductions in revenue in the current period. Other states may require us to meet certain performance and quality metrics in order to receive additional or full contractual revenue. For performance-based contracts, the Company does not recognize revenue subject to refund until data is sufficient to measure performance. Revenues are recorded based on membership and eligibility data provided by the states or CMS, which is adjusted on a monthly basis by the states or CMS for retroactive additions or deletions to membership data. These eligibility adjustments are estimated monthly and subsequent adjustments are made in the period known. The Company reviews and updates those estimates as new information becomes available. It is possible that new information could require us to make additional adjustments, which could be significant, to these estimates. The Company's Medicare Advantage contracts are with CMS. CMS deploys a risk adjustment model which apportions premiums paid to all health plans according to health severity and certain demographic factors. The CMS risk adjustment model pays more for members whose medical history would indicate that they are expected to have higher medical costs. Under this risk adjustment methodology, CMS calculates the risk adjusted premium payment using diagnosis data from hospital inpatient, hospital outpatient, physician treatment settings as well as prescription drug events. The Company and the healthcare providers collect, compile and submit the necessary and available diagnosis data to CMS within prescribed deadlines. The Company estimates risk adjustment revenues based upon the diagnosis data submitted and expected to be submitted to CMS and records revenues on a risk adjusted basis. For qualifying low-income prescription drug benefit members, CMS pays for some, or all, of the member's monthly premium. The Company receives certain Part D prospective subsidy payments from CMS for these members as a fixed monthly per member amount, based on the estimated costs of providing prescription drug benefits over the plan year, as reflected in its bids. Approximately nine to ten months subsequent to the end of the plan year, or later in the case of the coverage gap discount subsidy, a settlement payment is made between CMS and the Company's plans based on the difference between the prospective payments and actual claims experience. The Company's specialty companies generate revenues under contracts with state and federal programs, healthcare organizations and other commercial organizations, as well as from its own subsidiaries. Revenues are recognized when the related services are provided, when inventory is shipped, or as ratably earned over the covered period of services. For performance-based measures in the Company's contracts, revenue is recognized as data sufficient to measure performance is available. The Company recognizes revenue related to administrative services under the TRICARE government-sponsored Managed Care Support Contract for the Department of Defense (DoD's) TRICARE program on a straight-line basis over the option period, when the fees become fixed and determinable. The TRICARE contract includes various performance-based measures. For each of the measures, an estimate of the amount that has been earned is made at each interim date, and revenue is recognized accordingly. The Company concluded serving members at the end of 2024 upon the expiration of its TRICARE Managed Care Support Contract. Some states enact premium taxes, similar assessments and provider pass-through payments, collectively premium taxes, and these taxes are recorded as a separate component of both revenues and operating expenses. For certain products, premium taxes and state assessments are not pass-through payments and are recorded as premium revenue and premium tax expense in the Consolidated Statements of Operations. Some states require state directed payments that have minimal risk, but are administered as a premium adjustment. These payments are recorded as premium revenue and medical costs at close to a 100% health benefits ratio (HBR). In many instances, the Company has little visibility to the timing of these payments until they are paid by the state. Affordable Care Act The Affordable Care Act (ACA) established risk spreading premium stabilization programs as well as minimum MLR and cost sharing reductions (CSRs). The Company's accounting policies for the programs are as follows: Risk Adjustment The permanent risk adjustment program established by the ACA transfers funds from qualified individual and small group insurance plans with below average risk scores to those plans with above average risk scores within each state. The Company estimates the receivable or payable under the risk adjustment program based on its estimated risk score compared to the state average risk score. The Company may record a receivable or payable as an adjustment to premium revenues to reflect the year-to-date impact of the risk adjustment based on its best estimate. The Company refines its estimate as new information becomes available. Minimum Medical Loss Ratio Additionally, the ACA established a minimum MLR for the Health Insurance Marketplace. The risk adjustment program described above is taken into consideration to determine if the Company's estimated annual medical costs are less than the minimum MLR and require an adjustment to premium revenues to meet the minimum MLR. Cost Sharing Reductions The ACA directs issuers to reduce the Company's members' cost sharing for essential health benefits for individuals with Federal Poverty Levels (FPLs) between 100% and 250% who are enrolled in a silver tier product; eliminate cost sharing for Indians/Alaska Natives with a FPL less than 300% and eliminate cost sharing for Indians/Alaska Natives regardless of FPL when services are provided by an Indian Health Service. In October 2017, the Trump Administration issued an executive order that immediately ceased payments of CSRs to issuers, and beginning in 2018, premium rates for Health Insurance Marketplace were set without factoring in the cost sharing subsidy payments from the federal government. In 2024, the Company reached an agreement with the federal government to retroactively compensate the Company for the difference between its actual CSR experience and its pricing assumptions for 2018 through 2020. Premium and Trade Receivables and Unearned Revenue Premium and service revenues collected in advance are recorded as unearned revenue. For performance-based contracts, the Company does not recognize revenue subject to refund until data is sufficient to measure performance. Premiums and service revenues due to the Company are recorded as premium and trade receivables and are recorded net of an allowance based on historical trends and management's judgment on the collectability of these accounts. As the Company generally receives payments during the month in which services are provided, the allowance is typically not significant in comparison to total revenues and does not have a material impact on the presentation of the financial condition or results of operations. Amounts receivable under federal contracts are comprised primarily of contractually defined billings, accrued contract incentives under the terms of the contract and amounts related to change orders for services not originally specified in the contract. Year Ended December 31, 2024 2023 2022 Balance, January 1 $ 120 $ 130 $ 139 Amounts charged to expense 68 58 70 Write-offs of uncollectible receivables (77) (68) (79) Balance, December 31 $ 111 $ 120 $ 130 Significant Customers The Company receives the majority of its revenues under contracts or subcontracts with state Medicaid managed care programs. None of the Company's customers exceeded 10% of total annual revenues for the years ended December 31, 2024, 2023 and 2022. Other Income (Expense) Other income (expense) consists routinely of investment income, interest expense and equity method earnings from investments. Investment income is derived from the Company's cash, cash equivalents, restricted deposits and investments. Interest expense relates to borrowings under the senior notes, credit facilities, mortgage and construction loans and capital leases. Further, other income (expense) includes gains or losses on sales of investments, divestitures and acquisitions as well as debt extinguishment costs. Income Taxes Deferred tax assets and liabilities are recorded for the future tax consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax bases. Deferred tax assets and liabilities are measured using enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. The effect on deferred tax assets and liabilities of a change in tax law or tax rates is recognized in income in the period that includes the enactment date. Valuation allowances are provided when it is considered more likely than not that deferred tax assets will not be realized. In determining if a deductible temporary difference or net operating loss can be realized, the Company considers future reversals of existing taxable temporary differences, future taxable income, taxable income in prior carryback periods and tax planning strategies. Contingencies The Company accrues for loss contingencies associated with outstanding litigation, claims and assessments for which it has determined it is probable that a loss contingency exists and the amount of loss can be reasonably estimated. The Company expenses professional fees associated with litigation claims and assessments as incurred. Stock Based Compensation Stock based compensation expense is recognized at grant date fair value over the period during which an employee is required to provide service in exchange for the award. Excess tax benefits related to stock compensation are presented as a cash inflow from operating activities. The Company accounts for forfeitures when they occur. Recently Adopted Accounting Guidance In November 2023, the Financial Accounting Standards Board (FASB) issued Accounting Standards Update (ASU) 2023-07 - Segment Reporting: Improvements to Reportable Segment Disclosures which is intended to improve reportable segment disclosure requirements, primarily through enhanced disclosures about significant expenses. The amendments will require public entities to disclose significant segment expenses that are regularly provided to the chief operating decision-maker and included within segment profit and loss. The new standard is effective for annual periods beginning after December 15, 2023, and for interim periods within fiscal years beginning after December 15, 2024. The Company adopted the new guidance in the fourth quarter of 2024. In December 2023, the FASB issued ASU 2023-09 - Income taxes: Improvements to Income Tax Disclosures which includes amendments that further enhance income tax disclosures, primarily through standardization and disaggregation of rate reconciliation categories and income taxes paid by jurisdiction. The new standard is effective for annual periods beginning after December 15, 2024. The Company early adopted the new guidance in the fourth quarter of 2024, as permissible by the ASU. Recent Accounting Guidance Not Yet Adopted In November 2024, the FASB issued ASU 2024-03 - Income Statement - Reporting Comprehensive Income: Disaggregation of Income Statement Expenses which expands disclosures about specific expense categories presented on the face of the Statement of Operations. The new standard is effective for annual periods beginning after December 15, 2026, and interim periods beginning after December 15, 2027. The Company is currently evaluating the effect of the new disclosure requirements.

Acquisitions and Divestitures

Acquisitions and Divestitures	12 Months Ended
	Dec. 31, 2024
Business Combination, Asset Acquisition, and Joint Venture Formation [Abstract]
Acquisitions and Divestitures	Acquisitions and Divestitures Spanish and Central European Divestiture On November 16, 2022, the Company completed the divestiture of its ownership stakes in its Spanish and Central European businesses, including Ribera Salud, Torrejón Salud and Pro Diagnostics Group. During 2022, the Company recorded an impairment charge primarily related to intangible assets and goodwill associated with the divestiture of $163 million, or $140 million after-tax. In 2023, the Company recognized an additional loss on sale of $13 million, or $10 million after-tax, which is included in investment and other income in the Consolidated Statements of Operations. Magellan Rx Divestiture On December 2, 2022, the Company completed the divestiture of Magellan Rx for $1,337 million. The Company recognized a gain of $269 million, or $99 million after-tax, which is included in investment and other income in the Consolidated Statements of Operations. During 2023, the Company recorded a reduction to the previously reported gain on the divestiture of $22 million, or $10 million after-tax, due to the finalization of working capital adjustments. Magellan Specialty Health Divestiture On January 20, 2023, the Company completed the divestiture of Magellan Specialty Health for $646 million in cash and stock, including an estimated working capital adjustment, and recognized a gain of $79 million, or $68 million after-tax. The stock consideration was subsequently sold in April 2023 for cash proceeds of $245 million. During 2024, the Company recorded an additional gain on the previously reported divestiture of Magellan Specialty Health of $83 million for achievement of contingent consideration related to the sale and finalization of working capital adjustments, which is included in investment and other income in the Consolidated Statements of Operations. Centurion Divestiture On January 10, 2023, the Company signed and closed a definitive agreement to divest Centurion. During 2022, the Company recorded an impairment charge related to goodwill and other current assets associated with the divestiture of $259 million, or $181 million after-tax. During 2023, the Company recognized a gain of $15 million, or $10 million after-tax, reflecting additional proceeds for contingent consideration, partially offset by net working capital adjustments. The gain is included in investment and other income in the Consolidated Statements of Operations. HealthSmart Divestiture On January 5, 2023, the Company completed the divestiture of HealthSmart. During 2022, the Company recorded an impairment charge related to goodwill associated with the divestiture of $36 million, or $27 million after-tax. Apixio Divestiture On June 13, 2023, the Company completed the divestiture of its majority stake in Apixio. During 2023, the Company recognized a pre-tax gain of $93 million, or $67 million after-tax, which is included in investment and other income in the Consolidated Statements of Operations. Circle Health Group Divestiture On August 28, 2023, the Company signed a definitive agreement to sell Circle Health, one of the U.K.'s largest independent hospital operators, which is included in the Other segment. As of December 31, 2023, the assets and liabilities of Circle Health were considered held for sale resulting in $3,897 million of assets held for sale in other current assets and $3,094 million of liabilities held for sale in accounts payable and accrued expenses in the Consolidated Balance Sheets. The majority of the held for sale assets were previously reported as other long-term assets, goodwill and property, software and equipment. The majority of the liabilities were previously reported as debt and other long-term liabilities. In accordance with the signed definitive agreement in the third quarter of 2023, and subsequently updated in the fourth quarter of 2023, the Company recorded impairment charges related to goodwill associated with the pending divestiture totaling $292 million, or $258 million after-tax. In order to manage the foreign exchange risk on the sale price associated with the pending divestiture of Circle Health, in August 2023 the Company entered into a foreign currency swap agreement for a notional amount of $931 million, to sell £740 million. The swap agreement was formally designated and qualified as a cash flow hedge. The swap expired on the earlier of the divestiture closing date or March 28, 2024. The gain or loss due to changes in the fair value of the foreign currency swap was recorded in other comprehensive income until the Circle Health divestiture closed, at which time the gain or loss was recorded in earnings to the same line in the Consolidated Statements of Operations as the gain or loss on sale. The fair value of the swap agreement as of December 31, 2023 was $13 million, which was recorded in accounts payable and accrued expenses in the Consolidated Balance Sheets. On January 12, 2024, the Company completed the divestiture for $931 million and settled the foreign currency swap. Upon closing the divestiture, the Company settled the foreign currency swap and recorded a corresponding gain of $20 million, which includes the cumulative translation adjustment previously recorded in accumulated other comprehensive income in the Consolidated Balance Sheet. The gain is included in investment and other income in the Consolidated Statements of Operations. During the year ended December 31, 2024, the Company realized a net tax benefit of approximately $40 million on the loss recognized on the divestiture. Operose Health Group Divestiture In November 2023, the Company signed a definitive agreement to sell Operose Health and completed the divestiture on December 28, 2023. During 2023, the Company recorded impairment charges to Operose Health primarily related to goodwill, intangible assets and property, software and equipment of $140 million, or $128 million after-tax based on market indicators of fair value. Collaborative Health Systems Divestiture In July 2024, the Company entered into a definitive agreement to sell CHS, a management services organization, which is included in the Other segment. On October 4, 2024, the Company completed the previously announced sale of CHS. During 2024, the Company recognized a pre-tax gain of $17 million, or $13 million after-tax, which is included in investment and other income in the Consolidated Statements of Operations.

Short-term and Long-term Invest

Short-term and Long-term Investments, Restricted Deposits	12 Months Ended
	Dec. 31, 2024
Investments, Debt and Equity Securities [Abstract]
Short-term and Long-term Investments, Restricted Deposits	Short-term and Long-term Investments, Restricted Deposits Short-term and long-term investments and restricted deposits by investment type consist of the following ($ in millions): December 31, 2024 December 31, 2023 Amortized Cost Gross Gross Fair Value Amortized Cost Gross Gross Fair Value Debt securities: U.S. Treasury securities and obligations of U.S. government corporations and agencies $ 593 $ 2 $ (4) $ 591 $ 403 $ — $ (8) $ 395 Corporate securities 10,820 47 (360) 10,507 9,984 78 (461) 9,601 Restricted certificates of deposit 4 — — 4 4 — — 4 Restricted cash equivalents 93 — — 93 259 — — 259 Short-term time deposits 425 — — 425 746 — — 746 Municipal securities 4,174 7 (151) 4,030 4,135 21 (171) 3,985 Asset-backed securities 1,820 13 (21) 1,812 1,665 8 (35) 1,638 Residential mortgage-backed securities 1,807 1 (129) 1,679 1,503 7 (103) 1,407 Commercial mortgage-backed securities 1,298 3 (62) 1,239 1,149 5 (82) 1,072 Equity securities 14 — — 14 17 — — 17 Private equity investments 851 — — 851 833 — — 833 Life insurance contracts 196 — — 196 174 — — 174 Total $ 22,095 $ 73 $ (727) $ 21,441 $ 20,872 $ 119 $ (860) $ 20,131 The Company's investments are debt securities classified as available-for-sale with the exception of equity securities, certain private equity investments and life insurance contracts. Private equity investments include direct investments in private equity securities as well as private equity funds. In December 2024, the Company impaired a private equity investment for $50 million. The Company's investment policies are designed to provide liquidity, preserve capital and maximize total return on invested assets with a focus on high credit quality securities. The Company limits the size of investment in any single issuer other than U.S. treasury securities and obligations of U.S. government corporations and agencies. As of December 31, 2024, 99% of the Company's investments in rated securities carry an investment grade rating by nationally recognized statistical rating organizations. At December 31, 2024, the Company held certificates of deposit, equity securities, private equity investments and life insurance contracts, which did not carry a credit rating. Accrued interest income on available-for-sale debt securities was $178 million and $153 million at December 31, 2024 and 2023, respectively, and is included in other current assets The Company's residential mortgage-backed securities are primarily issued by the Federal National Mortgage Association, Government National Mortgage Association or Federal Home Loan Mortgage Corporation, which carry implicit or explicit guarantees of the U.S. government. The Company's commercial mortgage-backed securities are primarily senior tranches with a weighted average rating of AA+ and a weighted average duration of 3 years at December 31, 2024. The fair value of available-for-sale debt securities with gross unrealized losses by investment type and length of time that individual securities have been in a continuous unrealized loss position were as follows ($ in millions): December 31, 2024 December 31, 2023 Less Than 12 Months 12 Months or More Less Than 12 Months 12 Months or More Unrealized Losses Fair Value Unrealized Losses Fair Value Unrealized Losses Fair Value Unrealized Losses Fair Value U.S. Treasury securities and obligations of U.S. government corporations and agencies $ (1) $ 60 $ (3) $ 144 $ — $ 79 $ (8) $ 232 Corporate securities (41) 2,621 (319) 4,782 (6) 658 (455) 6,260 Municipal securities (16) 1,217 (135) 2,073 (4) 553 (167) 2,237 Asset-backed securities (4) 301 (17) 331 (2) 197 (33) 855 Residential mortgage-backed securities (18) 786 (111) 738 (2) 153 (101) 814 Commercial mortgage-backed securities (4) 210 (58) 666 (2) 114 (80) 754 Short-term time deposits — — — — — 31 — — Total $ (84) $ 5,195 $ (643) $ 8,734 $ (16) $ 1,785 $ (844) $ 11,152 As of December 31, 2024, the gross unrealized losses were generated from 5,276 positions out of a total of 6,750 positions. The change in fair value of available-for-sale debt securities is primarily a result of movement in interest rates subsequent to the purchase of the security. For each security in an unrealized loss position, the Company assesses whether it intends to sell the security or if it is more likely than not the Company will be required to sell the security before recovery of the amortized cost basis for reasons such as liquidity, contractual or regulatory purposes. If the security meets this criterion, the decline in fair value is recorded in earnings. The Company does not intend to sell these securities prior to maturity and it is not likely that the Company will be required to sell these securities prior to maturity; therefore, the Company did not record an impairment for these securities. In addition, the Company monitors available-for-sale debt securities for credit losses. Certain investments have experienced a decline in fair value due to changes in credit quality, market interest rates and/or general economic conditions. The Company recognizes an allowance when evidence demonstrates that the decline in fair value is credit related. Evidence of a credit-related loss may include rating agency actions, adverse conditions specifically related to the security or failure of the issuer of the security to make scheduled payments. The contractual maturities of short-term and long-term debt securities and restricted deposits are as follows ($ in millions): December 31, 2024 December 31, 2023 Investments Restricted Deposits Investments Restricted Deposits Amortized Cost Fair Value Amortized Cost Fair Value Amortized Cost Fair Value Amortized Cost Fair Value One year or less $ 2,383 $ 2,365 $ 477 $ 475 $ 2,308 $ 2,284 $ 566 $ 564 One year through five years 7,799 7,563 610 593 7,738 7,431 527 504 Five years through ten years 4,343 4,172 301 291 3,905 3,735 298 283 Greater than ten years 165 160 31 31 155 154 34 35 Asset-backed securities 4,925 4,730 — — 4,317 4,117 — — Total $ 19,615 $ 18,990 $ 1,419 $ 1,390 $ 18,423 $ 17,721 $ 1,425 $ 1,386 Actual maturities may differ from contractual maturities due to call or prepayment options. Equity securities, private equity investments and life insurance contracts are excluded from the table above because they do not have a contractual maturity. The Company has an option to redeem substantially all of the securities included in the greater than ten years category listed above at amortized cost.

Fair Value Measurements

Fair Value Measurements	12 Months Ended
	Dec. 31, 2024
Fair Value Disclosures [Abstract]
Fair Value Measurements	Fair Value Measurements Assets and liabilities recorded at fair value in the Consolidated Balance Sheets are categorized based upon observable or unobservable inputs used to estimate fair value. Level inputs are as follows: Level Input: Input Definition: Level I Inputs are unadjusted, quoted prices for identical assets or liabilities in active markets at the measurement date. Level II Inputs other than quoted prices included in Level I that are observable for the asset or liability through corroboration with market data at the measurement date. Level III Unobservable inputs that reflect management's best estimate of what market participants would use in pricing the asset or liability at the measurement date. The following table summarizes fair value measurements by level at December 31, 2024, for assets and liabilities measured at fair value on a recurring basis ($ in millions): Level I Level II Level III Total Assets Cash and cash equivalents $ 14,063 $ — $ — $ 14,063 Investments: U.S. Treasury securities and obligations of U.S. government corporations and agencies $ 58 $ — $ — $ 58 Corporate securities — 10,505 — 10,505 Municipal securities — 3,272 — 3,272 Short-term time deposits — 425 — 425 Asset-backed securities — 1,812 — 1,812 Residential mortgage-backed securities — 1,679 — 1,679 Commercial mortgage-backed securities — 1,239 — 1,239 Equity securities 13 1 — 14 Total investments $ 71 $ 18,933 $ — $ 19,004 Restricted deposits: Cash and cash equivalents $ 93 $ — $ — $ 93 U.S. Treasury securities and obligations of U.S. government corporations and agencies 533 — 533 Corporate securities — 2 — 2 Certificates of deposit — 4 — 4 Municipal securities — 758 — 758 Total restricted deposits $ 626 $ 764 $ — $ 1,390 Total assets at fair value $ 14,760 $ 19,697 $ — $ 34,457 The following table summarizes fair value measurements by level at December 31, 2023, for assets and liabilities measured at fair value on a recurring basis ($ in millions): Level I Level II Level III Total Assets Cash and cash equivalents $ 17,193 $ — $ — $ 17,193 Investments: U.S. Treasury securities and obligations of U.S. government corporations and agencies $ 62 $ — $ — $ 62 Corporate securities — 9,564 — 9,564 Municipal securities — 3,232 — 3,232 Short-term time deposits — 746 — 746 Asset-backed securities — 1,638 — 1,638 Residential mortgage-backed securities — 1,407 — 1,407 Commercial mortgage-backed securities — 1,072 — 1,072 Equity securities 15 2 — 17 Total investments $ 77 $ 17,661 $ — $ 17,738 Restricted deposits: Cash and cash equivalents $ 259 $ — $ — $ 259 U.S. Treasury securities and obligations of U.S. government corporations and agencies 333 — — 333 Corporate securities — 37 — 37 Certificates of deposit — 4 — 4 Municipal securities — 753 — 753 Total restricted deposits $ 592 $ 794 $ — $ 1,386 Total assets at fair value $ 17,862 $ 18,455 $ — $ 36,317 Liabilities Accounts payable and accrued expenses: Foreign currency swap agreement $ — $ 13 $ — $ 13 Total liabilities at fair value $ — $ 13 $ — $ 13 The Company utilizes matrix pricing services to estimate fair value for securities which are not actively traded on the measurement date. The Company designates these securities as Level II fair value measurements. In addition, the aggregate carrying amount of the Company's private equity investments and life insurance contracts, which approximates fair value, was $1,047 million and $1,007 million as of December 31, 2024 and December 31, 2023, respectively.

Property, Software and Equipmen

Property, Software and Equipment	12 Months Ended
	Dec. 31, 2024
Property, Plant and Equipment [Abstract]
Property, Software and Equipment	Property, Software and Equipment Property, software and equipment consist of the following ($ in millions): December 31, 2024 December 31, 2023 Computer software $ 3,051 $ 2,631 Computer hardware 535 542 Buildings 523 534 Furniture and office equipment 332 304 Leasehold improvements 273 252 Land 156 156 Property, software and equipment, at cost 4,870 4,419 Less: accumulated depreciation (2,803) (2,400) Property, software and equipment, net $ 2,067 $ 2,019 Depreciation expense for the years ended December 31, 2024, 2023 and 2022 was $549 million, $575 million and $614 million, respectively. During the second quarter of 2022, in connection with the adoption of a more modern, flexible work environment, the Company undertook a real estate optimization initiative to evaluate future real estate needs and downsize its real estate footprint for owned and leased properties. As a result of this evaluation, the Company substantially changed the use or abandoned various properties and assessed for impairment. The Company engaged a third-party real estate specialist to determine the fair value of its owned properties. The valuation primarily considered comparable properties in each market as well as future cash flows. As a result of the optimization, the Company recognized impairment charges related to owned real estate and fixed assets related to leased real estate of $57 million and $1,050 million for the years ended December 31, 2023 and 2022, respectively. The remainder of the $97 million and $1,627 million impairment charges for the years ended December 31, 2023 and 2022, respectively, relate to right-of-use (ROU) asset impairments, which is included within other long-term assets in the Consolidated Balance Sheets, refer to Note 11. Leases. Additionally, during 2024, the Company sold an owned property for a pre-tax gain of $24 million.

Goodwill and Intangible Assets

Goodwill and Intangible Assets	12 Months Ended
	Dec. 31, 2024
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill and Intangible Assets	Goodwill and Intangible Assets The following table summarizes the changes in goodwill by operating segment ($ in millions): Medicaid Medicare Commercial Other Consolidated Total Balance, December 31, 2022 $ 10,198 $ 1,592 $ 5,424 $ 1,598 $ 18,812 Divestitures — — — (912) (912) Impairments — — — (392) (392) Translation impact — — — 50 50 Balance, December 31, 2023 $ 10,198 $ 1,592 $ 5,424 $ 344 $ 17,558 Current year activity — — — — — Balance, December 31, 2024 $ 10,198 $ 1,592 $ 5,424 $ 344 $ 17,558 In 2023, divestiture related activity in goodwill included the completed divestiture of Apixio as well as $760 million of goodwill reclassified to other current assets associated with the divestiture of Circle Health, which was considered held for sale as of December 31, 2023. The Company's Other segment impairments in 2023 were driven by the Circle Health and Operose Health divestitures. Intangible assets at December 31, consist of the following ($ in millions): Weighted Average Useful Life in Years 2024 2023 2024 2023 Purchased contract rights and customer relationships $ 7,845 $ 7,845 13.5 13.5 Trade names 943 943 15.6 15.6 Provider contracts 612 612 14.0 14.0 Developed technologies 298 298 4.4 4.4 Intangible assets 9,698 9,698 13.4 13.4 Less: accumulated amortization Purchased contract rights and customer relationships (3,348) (2,768) Trade names (383) (320) Provider contracts (271) (227) Developed technologies (287) (282) Total accumulated amortization (4,289) (3,597) Intangible assets, net $ 5,409 $ 6,101 Amortization expense was $692 million, $718 million and $817 million for the years ended December 31, 2024, 2023 and 2022, respectively. Estimated total amortization expense related to the December 31, 2024 intangible assets for each of the five succeeding fiscal years is as follows ($ in millions): Estimated Total Amortization Expense 2025 $ 690 2026 673 2027 663 2028 662 2029 558

Medical Claims Liability

Medical Claims Liability	12 Months Ended
	Dec. 31, 2024
Insurance [Abstract]
Medical Claims Liability	Medical Claims Liability The following table summarizes the change in medical claims liability for the year ended December 31, 2024 ($ in millions): Medicaid Medicare Commercial Other Consolidated Total Balance, January 1, 2024 $ 10,814 $ 3,612 $ 3,460 $ 114 $ 18,000 Less: Reinsurance recoverables 5 — 44 — 49 Balance, January 1, 2024, net 10,809 3,612 3,416 114 17,951 Incurred related to: Current year 78,886 21,170 26,548 1,708 128,312 Prior years (1,370) (575) (509) 7 (2,447) Total incurred 77,516 20,595 26,039 1,715 125,865 Paid related to: Current year 69,351 18,036 22,547 1,522 111,456 Prior years 8,693 2,655 2,492 119 13,959 Total paid 78,044 20,691 25,039 1,641 125,415 Plus: Premium deficiency reserve — (158) — — (158) Balance, December 31, 2024, net 10,281 3,358 4,416 188 18,243 Plus: Reinsurance recoverables 18 — 47 — 65 Balance, December 31, 2024 $ 10,299 $ 3,358 $ 4,463 $ 188 $ 18,308 The following table summarizes the change in medical claims liability for the year ended December 31, 2023 ($ in millions): Medicaid Medicare Commercial Other Consolidated Total Balance, January 1, 2023 $ 11,253 $ 3,431 $ 1,921 $ 140 $ 16,745 Less: Reinsurance recoverables 7 — 19 — 26 Balance, January 1, 2023, net 11,246 3,431 1,902 140 16,719 Incurred related to: Current year 79,747 19,487 19,966 1,480 120,680 Prior years (1,537) (343) (150) (6) (2,036) Total incurred 78,210 19,144 19,816 1,474 118,644 Paid related to: Current year 69,904 16,631 16,823 1,367 104,725 Prior years 8,743 2,582 1,479 133 12,937 Total paid 78,647 19,213 18,302 1,500 117,662 Plus: Premium deficiency reserve — 250 — — 250 Balance, December 31, 2023, net 10,809 3,612 3,416 114 17,951 Plus: Reinsurance recoverables 5 — 44 — 49 Balance, December 31, 2023 $ 10,814 $ 3,612 $ 3,460 $ 114 $ 18,000 The following table summarizes the change in medical claims liability for the year ended December 31, 2022 ($ in millions): Medicaid Medicare Commercial Other Consolidated Total Balance, January 1, 2022 $ 9,845 $ 2,286 $ 2,014 $ 98 $ 14,243 Less: Reinsurance recoverables 23 — — — 23 Balance, January 1, 2022, net 9,822 2,286 2,014 98 14,220 Acquisitions and divestitures — — — 105 105 Incurred related to: Current year 76,344 19,474 14,296 2,782 112,896 Prior years (1,046) (102) (204) (15) (1,367) Total incurred 75,298 19,372 14,092 2,767 111,529 Paid related to: Current year 66,221 16,275 12,556 2,747 97,799 Prior years 7,653 1,952 1,648 83 11,336 Total paid 73,874 18,227 14,204 2,830 109,135 Balance, December 31, 2022, net 11,246 3,431 1,902 140 16,719 Plus: Reinsurance recoverables 7 — 19 — 26 Balance, December 31, 2022 $ 11,253 $ 3,431 $ 1,921 $ 140 $ 16,745 Reinsurance recoverables related to medical claims are included in premium and trade receivables. Changes in estimates of incurred claims for prior years were primarily attributable to reserving under moderately adverse conditions, including residual pandemic impacts. Additionally, as a result of minimum MLR and other return of premium programs, the Company recorded approximately $243 million, $382 million and $198 million of the "Incurred related to: Prior years" as a reduction to premium revenues in 2024, 2023 and 2022, respectively. Further, claims processing and coordination of benefits initiatives yielded claim payment recoveries related to dates of service from prior years. Changes in medical utilization, claims submission patterns, and cost trends and the effect of population health management initiatives may also contribute to changes in medical claim liability estimates. While the Company has evidence that population health management initiatives are effective on a case by case basis, population health management initiatives primarily focus on events and behaviors prior to the incurrence of the medical event and generation of a claim. Accordingly, any change in behavior, leveling of care or coordination of treatment occurs prior to claim generation and as a result, the costs prior to the population health management initiative are not known by the Company. Additionally, certain population health management initiatives are focused on member and provider education with the intent of influencing behavior to appropriately align the medical services provided with the member's acuity. In these cases, determining whether the population health management initiative changed the behavior cannot be determined. Because of the complexity of its business, the number of states in which it operates and the volume of claims that it processes, the Company is unable to practically quantify the impact of these initiatives on its changes in estimates of IBNR. The Company reviews actual and anticipated experience compared to the assumptions used to establish medical costs. The Company establishes premium deficiency reserves if actual and anticipated experience indicates that existing policy liabilities together with the present value of future gross premiums will not be sufficient to cover the present value of future benefits, settlement and maintenance costs. For purposes of determining premium deficiencies, contracts are grouped in a manner consistent with the method of acquiring, servicing and measuring the profitability of such contracts and expected investment income is excluded. In December 2023, the Company recorded a premium deficiency reserve of $250 million related to the 2024 Medicare Advantage contract year. In December 2024, the Company recorded a premium deficiency reserve of $92 million related to the 2025 Medicare Advantage contract year. Information about incurred and paid claims development as of December 31, 2024 is included in the table below. The claims development information for all periods preceding the most recent reporting period is considered required supplementary information. Consolidated incurred and paid claims development as of December 31, 2024 is as follows ($ in millions): Cumulative Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance For the Year Ended December 31, Claim Year 2022 (unaudited) 2023 (unaudited) 2024 2022 $ 112,896 $ 110,870 $ 110,394 2023 120,680 118,709 2024 128,312 Total incurred claims $ 357,415 Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance For the Year Ended December 31, Claim Year 2022 (unaudited) 2023 (unaudited) 2024 2022 $ 97,799 $ 109,680 $ 110,097 2023 104,725 117,635 2024 111,456 Total payment of incurred claims 339,188 All outstanding liabilities prior to 2022, net of reinsurance 174 Medical claims liability, net of reinsurance $ 18,401 Incurred and paid claims development for the Medicaid segment as of December 31, 2024 is as follows ($ in millions): Cumulative Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance For the Year Ended December 31, Claim Year 2022 (unaudited) 2023 (unaudited) 2024 2022 $ 76,344 $ 74,861 $ 74,722 2023 79,747 78,517 2024 78,885 Total incurred claims $ 232,124 Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance For the Year Ended December 31, Claim Year 2022 (unaudited) 2023 (unaudited) 2024 2022 $ 66,220 $ 74,125 $ 74,608 2023 69,904 77,952 2024 69,351 Total payment of incurred claims 221,911 All outstanding liabilities prior to 2022, net of reinsurance 68 Medical claims liability, net of reinsurance $ 10,281 Incurred and paid claims development for the Medicare segment as of December 31, 2024 is as follows ($ in millions): Cumulative Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance For the Year Ended December 31, Claim Year 2022 (unaudited) 2023 (unaudited) 2024 2022 $ 19,475 $ 19,124 $ 19,027 2023 19,487 19,008 2024 21,171 Total incurred claims $ 59,206 Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance For the Year Ended December 31, Claim Year 2022 (unaudited) 2023 (unaudited) 2024 2022 $ 16,276 $ 18,818 $ 18,942 2023 16,631 18,778 2024 18,036 Total payment of incurred claims 55,756 All outstanding liabilities prior to 2022, net of reinsurance 66 Medical claims liability, net of reinsurance $ 3,516 Incurred and paid claims development for the Commercial segment as of December 31, 2024 is as follows ($ in millions): Cumulative Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance For the Year Ended December 31, Claim Year 2022 (unaudited) 2023 (unaudited) 2024 2022 $ 14,296 $ 14,110 $ 13,870 2023 19,966 19,698 2024 26,548 Total incurred claims $ 60,116 Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance For the Year Ended December 31, Claim Year 2022 (unaudited) 2023 (unaudited) 2024 2022 $ 12,556 $ 13,963 $ 13,773 2023 16,823 19,420 2024 22,547 Total payment of incurred claims 55,740 All outstanding liabilities prior to 2022, net of reinsurance 40 Medical claims liability, net of reinsurance $ 4,416 Incurred and paid claims development for the Other segment as of December 31, 2024 is as follows ($ in millions): Cumulative Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance For the Year Ended December 31, Claim Year 2022 (unaudited) 2023 (unaudited) 2024 2022 $ 2,781 $ 2,775 $ 2,775 2023 1,480 1,486 2024 1,708 Total incurred claims $ 5,969 Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance For the Year Ended December 31, Claim Year 2022 (unaudited) 2023 (unaudited) 2024 2022 $ 2,747 $ 2,774 $ 2,774 2023 1,367 1,485 2024 1,522 Total payment of incurred claims 5,781 All outstanding liabilities prior to 2022, net of reinsurance — Medical claims liability, net of reinsurance $ 188 Incurred claims and allocated claim adjustment expenses, net of reinsurance, total IBNR plus expected development on reported claims and cumulative claims data as of December 31, 2024 are included in the following table. For claims frequency information summarized below, a claim is defined as the financial settlement of a single medical event in which remuneration was paid to the servicing provider. Total IBNR plus expected development on reported claims represents estimates for claims incurred but not reported, development on reported claims and estimates for the costs necessary to process unpaid claims at the end of each period. The Company estimates its liability using actuarial methods that are commonly used by health insurance actuaries and meet Actuarial Standards of Practice. These actuarial methods consider factors such as historical data for payment patterns, cost trends, product mix, seasonality, utilization of healthcare services and other relevant factors. Consolidated information is summarized as follows (in millions): December 31, 2024 Incurred Claims and Allocated Claim Total IBNR Plus Expected Cumulative Paid Claims 2022 $ 110,394 $ 3 638.0 2023 118,709 383 623.6 2024 128,312 12,079 641.3 Information for the Medicaid segment is summarized as follows (in millions): December 31, 2024 Incurred Claims and Allocated Claim Total IBNR Plus Expected Cumulative Paid Claims 2022 $ 74,722 $ 3 370.9 2023 78,517 218 345.6 2024 78,885 6,968 300.1 Information for the Medicare segment is summarized as follows (in millions): December 31, 2024 Incurred Claims and Allocated Claim Total IBNR Plus Expected Cumulative Paid Claims 2022 $ 19,027 $ — 204.8 2023 19,008 102 200.6 2024 21,171 1,724 253.0 Information for the Commercial segment is summarized as follows (in millions): December 31, 2024 Incurred Claims and Allocated Claim Total IBNR Plus Expected Cumulative Paid Claims 2022 $ 13,870 $ — 57.5 2023 19,698 62 72.9 2024 26,548 3,211 83.0 Information for the Other segment is summarized as follows (in millions): December 31, 2024 Incurred Claims and Allocated Claim Total IBNR Plus Expected Cumulative Paid Claims 2022 $ 2,775 $ — 4.8 2023 1,486 1 4.5 2024 1,708 176 5.2

Affordable Care Act

Affordable Care Act	12 Months Ended
	Dec. 31, 2024
Affordable Care Act [Abstract]
Affordable Care Act	Affordable Care Act The ACA established risk spreading premium stabilization programs as well as a minimum annual MLR and CSRs. The Company's net receivables (payables) for each of the programs are as follows ($ in millions): December 31, 2024 December 31, 2023 Risk adjustment receivable $ 1,434 $ 893 Risk adjustment payable (1,605) (2,553) Minimum medical loss ratio (688) (164) Cost sharing reduction receivable 305 — Cost sharing reduction payable (74) (114) In July 2024, CMS announced the final risk adjustment transfers for the 2023 benefit year. As a result of the announcement, the risk adjustment net payable was decreased by $1,475 million in the twelve months ended December 31, 2024. After consideration of minimum MLR and other related impacts, which includes the effect to the 2024 benefit year, the net pre-tax benefit recognized was $853 million for the year ended December 31, 2024. In October 2017, the Trump Administration issued an executive order that immediately ceased payments of CSRs to issuers, and beginning in 2018, premium rates for Health Insurance Marketplace were set without factoring in the cost sharing subsidy payments from the federal government. In 2024, the Company reached an agreement with the federal government to retroactively compensate the Company $299 million (gross) for the difference between its actual CSR experience and its pricing assumptions for 2018 through 2020.

Debt

Debt	12 Months Ended
	Dec. 31, 2024
Debt Disclosure [Abstract]
Debt	Debt Debt consists of the following ($ in millions): December 31, 2024 December 31, 2023 $2,500 million 4.25% Senior Notes, due December 15, 2027 $ 2,398 $ 2,395 $2,300 million 2.45% Senior Notes, due July 15, 2028 2,302 2,303 $3,500 million 4.625% Senior Notes, due December 15, 2029 3,277 3,277 $2,000 million 3.375% Senior Notes, due February 15, 2030 2,000 2,000 $2,200 million 3.00% Senior Notes, due October 15, 2030 2,200 2,200 $2,200 million 2.50% Senior Notes, due March 1, 2031 2,200 2,200 $1,300 million 2.625% Senior Notes, due August 1, 2031 1,300 1,300 Total senior notes 15,677 15,675 Term Loan Facility 2,006 2,115 Revolving Credit Agreement 950 150 Finance leases and other — 11 Debt issuance costs (100) (122) Total debt 18,533 17,829 Less: current portion (110) (119) Long-term debt $ 18,423 $ 17,710 Senior Notes The indentures governing the senior notes listed in the table above contain restrictive covenants of Centene Corporation. At December 31, 2024, the Company was in compliance with all covenants. Circle Health Debt Refinancing In May 2022, the Company refinanced certain debt agreements for its Circle Health subsidiary with a new £250 million credit facility maturing in May 2025. The Company recognized a $13 million pre-tax gain on the extinguishment of the existing debt. As of December 31, 2023, £150 million was drawn on the facility, and was included in accounts payable and accrued expenses in the Consolidated Balance Sheets as a liability held for sale. The facility is guaranteed by the Company and has similar borrowing rates and covenants to the Company's Revolving Credit Agreement, except it uses the Sterling Overnight Index Average (SONIA) as the reference rate for the interest rate payable. In January 2024, the Company completed the divestiture of Circle Health and terminated the credit facility. Revolving Credit Facility and Term Loan Credit Facility In May 2023, the Company entered into a first amendment to the Company's Fourth Amended and Restated Credit Agreement. The amendment removed and replaced the interest rate benchmark based on the London Interbank Offered Rate (LIBOR) and related LIBOR-based mechanics applicable to U.S. dollar borrowings under the Amended and Restated Credit Agreement with an interest rate benchmark based on the Secured Overnight Financing Rate (SOFR) (including a customary credit spread adjustment) and related SOFR-based mechanics. Additionally, the amendment removed certain provisions which required the Company to make certain mandatory prepayments of the Term Loan Facility. The Company has (i) unsecured $2,000 million multi-currency revolving credit facility (the Revolving Credit Facility), which includes a $300 million sub-limit for letters of credit and a $200 million sub-limit for swingline loans and (ii) a $2,200 million unsecured delayed-draw term loan facility (the Term Loan Facility, and together with the Revolving Credit Facility, the Company Credit Facility). Borrowings under the Revolving Credit Facility bear interest, at the Company's option, at SOFR, SONIA, Euro Interbank Offered Rate (EURIBOR), Swiss Average Rate Overnight (SARON), Tokyo Interbank Offered Rate (TIBOR), Bank Buying Rate (BBR) or base rates plus, in each case, an applicable margin between 1.50% to 1.125%, based on the total debt-to-EBITDA ratio and type of borrowing. Borrowings under the Term Loan Facility bear interest, at the Company's option, at SOFR or base rates plus, in each case, an applicable margin based on the total debt-to-EBITDA ratio. The Company has an uncommitted option to increase its Company Credit Facility by an additional $500 million plus certain additional amounts based on its total debt-to-EBITDA ratio. The Term Loan Facility includes scheduled amortization payments equal to 0% for the first year following closing, 2.5% for the second year following closing and 5% thereafter until maturity. The Company Credit Facility contains financial covenants including maintenance of a minimum fixed charge coverage ratio and a restriction on the Company's maximum total debt-to-EBITDA ratio not to exceed 4.0 to 1.0. It also contains certain non-financial covenants including: limitations on incurrence of additional indebtedness; restrictions on incurrence of liens; restrictions on dividends and other restricted payments; restrictions on investments, mergers, consolidations and asset sales; and limitations on transactions with affiliates. As of December 31, 2024, the Company was in compliance with all financial and non-financial covenants under the Company Credit Facility. As of December 31, 2024, the Company had $950 million of borrowings outstanding under the Revolving Credit Facility, with an interest rate of the base rate plus 0.25% margin, and $2,006 million of borrowings outstanding under the Company's Term Loan Facility. The Revolving Credit Facility and the Term Loan Facility will mature on August 16, 2026. Senior Note Debt Repurchase Program In June 2022, the Company's Board of Directors authorized a $1,000 million senior note debt repurchase program in preparation for future debt reductions as part of the Company's strategic initiatives. No repurchases were made during the year ended December 31, 2024 and 2023. As of December 31, 2024, there was $700 million available under the senior note debt repurchase program. Letters of Credit & Surety Bonds The Company had outstanding letters of credit of $145 million as of December 31, 2024, which were not part of the Revolving Credit Facility. The letters of credit bore interest at 0.7% as of December 31, 2024. The Company had outstanding surety bonds of $844 million as of December 31, 2024. Aggregate maturities for the Company's debt for the years ending December 31, are as follows ($ in millions): Aggregate Maturities 2025 $ 110 2026 2,848 2027 2,405 2028 2,300 2029 3,277 Thereafter 7,700 Total $ 18,640 The fair value of outstanding debt was approximately $16,929 million and $16,322 million at December 31, 2024 and 2023, respectively.

Leases

Leases	12 Months Ended
	Dec. 31, 2024
Leases [Abstract]
Leases	Leases The Company records ROU assets and lease liabilities for non-cancelable operating leases primarily for real estate and equipment. Leases with an initial term of 12 months or less are not recorded on the balance sheet. Expense related to leases is recorded on a straight-line basis over the lease term, including rent holidays. The Company recognized operating lease expense of $108 million and $349 million during the years ended December 31, 2024 and 2023, respectively. The Company considers the existence of options to extend or terminate leases in its analysis of the lease term for the purposes of measuring its ROU assets and lease liabilities. The renewal options are not included in the measurement of the ROU assets and lease liabilities unless the Company is reasonably certain to exercise the optional renewal periods. The following table sets forth the ROU assets and lease liabilities ($ in millions): December 31, 2024 December 31, 2023 Assets ROU assets (recorded within other long-term assets) $ 359 $ 396 Liabilities Short-term (recorded within accounts payable and accrued expenses) $ 158 $ 168 Long-term (recorded within other long-term liabilities) 738 880 Total lease liabilities $ 896 $ 1,048 Cash paid for amounts included in the measurement of lease liabilities, recorded as operating cash flows in the Consolidated Statements of Cash Flows, was $227 million and $378 million during the years ended December 31, 2024 and 2023, respectively. New operating leases commenced resulting in the recognition of ROU assets and lease liabilities of $69 million and $40 million during the years ended December 31, 2024 and 2023, respectively. As of December 31, 2024, the Company had additional operating leases that have not yet commenced of $8 million. These operating leases will commence in 2025 with lease terms of approximately five years. As part of the real estate optimization initiative as described in Note 6. Property, Software and Equipment , the Company vacated and abandoned various domestic leased properties. As a result, the Company assessed the ROU assets for impairment. The Company engaged a third-party real estate specialist to determine the recoverability of the leased properties. The valuation primarily considered comparable leased properties in each market and the assessment of potential future rental income that could be generated by the ROU assets. As a result of the real estate optimization initiative, the Company recognized $40 million and $577 million of ROU asset impairments for the years ended December 31, 2023 and 2022, respectively. The remainder of the $97 million and $1,627 million real estate optimization impairment charges for the years ended December 31, 2023 and 2022, respectively, was related to Property, Software and Equipment, refer to Note 6. Property, Software and Equipment . No impairment charges related to this optimization occurred in 2024. As of December 31, 2024, the weighted average remaining lease term for the Company was 7.5 years. The lease liabilities as of December 31, 2024, reflect a weighted average discount rate of 3.4%. Lease payments over the next five years and thereafter are as follows ($ in millions): Lease Payments 2025 $ 185 2026 157 2027 134 2028 112 2029 98 Thereafter 334 Total lease payments 1,020 Less: imputed interest (124) Total lease liabilities $ 896

Stockholders' Equity

Stockholders' Equity	12 Months Ended
	Dec. 31, 2024
Equity [Abstract]
Stockholders' Equity	Stockholders' Equity The Company's Board of Directors has authorized a stock repurchase program of the Company's common stock from time to time on the open market or through privately negotiated transactions. In 2023, the Company's Board of Directors authorized an increase under the program of $4,000 million. With these increases, the Company is authorized to repurchase up to $10,000 million, inclusive of past authorizations. As of December 31, 2024, the Company had a remaining amount of $2,230 million available under the Company's stock repurchase program. No duration has been placed on the repurchase program. The Company reserves the right to discontinue the repurchase program at any time. Share repurchases in 2024, 2023 and 2022 were primarily funded through divestiture proceeds and free cash flow generated from operations. The following represents the Company's share repurchase activity ($ in millions, shares in thousands): Year Ended December 31, 2024 2023 2022 (2) Shares Cost Shares Cost Shares Cost Share buybacks 41,987 $ 2,999 22,886 $ 1,577 35,655 $ 2,994 Income tax withholding 1,494 114 828 56 1,213 102 Total share repurchases (1) 43,481 $ 3,113 23,714 $ 1,633 36,868 $ 3,096 (1) Excludes year-to-date share repurchase excise tax of approximately $28 million and $10 million accrued as of December 31, 2024 and 2023, respectively. (2) Includes 11.6 million shares delivered as part of an accelerated share repurchase (ASR) agreement with a $1,000 million notional amount. The Company purchased additional shares throughout the year through open market repurchases, including repurchase plans designed to comply with Rule 10b5-1. Shares repurchased for income tax withholding are shares withheld in connection with employee stock plans to meet applicable tax withholding requirements. These shares are typically included in the Company's treasury stock.

Statutory Capital Requirements

Statutory Capital Requirements and Dividend Restrictions	12 Months Ended
	Dec. 31, 2024
Statutory Capital Requirements And Dividend Restrictions [Abstract]
Statutory Capital Requirements and Dividend Restrictions	Statutory Capital Requirements and Dividend Restrictions

Income Taxes

Income Taxes	12 Months Ended
	Dec. 31, 2024
Income Tax Disclosure [Abstract]
Income Taxes	Income Taxes The consolidated income tax expense consists of the following ($ in millions): Year Ended December 31, 2024 2023 2022 Income (loss) from continuing operations before income tax expense (benefit) U.S. Federal $ 3,529 $ 3,686 $ 1,938 Foreign (1) 728 (88) 24 Total $ 4,257 $ 3,598 $ 1,962 Income tax expense (benefit) from continuing operations Current tax expense Federal $ 798 $ 833 $ 1,144 State and local 142 132 261 Foreign — 1 4 Total current tax expense $ 940 $ 966 $ 1,409 Deferred tax expense (benefit) Federal $ 8 $ (71) $ (514) State and local 7 33 (126) Foreign 8 (29) (9) Total deferred tax expense (benefit) $ 23 $ (67) $ (649) Total income tax expense (benefit) Federal $ 806 $ 762 $ 630 State and local 149 165 135 Foreign 8 (28) (5) Total income tax expense (benefit) $ 963 $ 899 $ 760 (1) Foreign income from continuing operations includes the Company's Cayman Islands reinsurance entity. The Company has elected for its Cayman Islands entity to be taxed as a U.S. corporation and pays U.S. tax at the 21% tax rate. The U.S. tax resulting from this entity is included in Federal income tax expense. This entity is expected to cease operating in 2025. The reconciliation of the tax provision at the U.S. federal statutory rate to income tax expense is as follows ($ in millions): Year Ended December 31, 2024 2023 2022 Total % Total % Total % Earnings from continuing operations, before income tax expense $ 4,257 $ 3,598 $ 1,962 Tax provision at the U.S. federal statutory rate 894 21.0 % 756 21.0 % 412 21.0 % Federal Effect of cross-border tax laws Global Intangible Low-Taxed Income (GILTI) 44 1.0 % 4 0.1 % — — % Cayman Islands Statutory income tax rate differential (1) 142 3.3 % 62 1.7 % 6 0.3 % Other 2 — % (21) (0.6) % (1) (0.1) % Tax credits (14) (0.3) % (5) (0.1) % (8) (0.4) % Changes in valuation allowances (12) (0.3) % (2) (0.1) % (11) (0.6) % Nontaxable or nondeductible items Nondeductible compensation 37 0.9 % 29 0.8 % 51 2.6 % Nondeductible goodwill — — % — — % 56 2.9 % Nontaxable or nondeductible divestiture (gains) losses (97) (2.3) % (9) (0.3) % 79 4.0 % Other nontaxable or nondeductible items (1) — % (6) (0.2) % 13 0.7 % Other Deferred taxes for investments in subsidiaries — — % — — % 70 3.6 % Excess tax benefit on stock awards (3) (0.1) % (59) (1.6) % (13) (0.7) % Other 9 0.2 % 26 0.7 % 29 1.5 % Foreign tax effects United Kingdom Nondeductible goodwill (34) (0.8) % 83 2.3 % — — % Other 12 0.3 % (26) (0.7) % (2) (0.1) % Cayman Islands Statutory income tax rate differential (1) (142) (3.3) % (62) (1.7) % (6) (0.3) % Other jurisdictions 7 0.2 % (16) (0.4) % — — % Changes in unrecognized tax benefits 24 0.6 % 27 0.8 % 13 0.7 % State income taxes, net of federal income tax benefit (2) 95 2.2 % 118 3.3 % 72 3.7 % Income tax expense $ 963 22.6 % $ 899 25.0 % $ 760 38.7 % (1) The Company has elected for its Cayman Islands reinsurance entity to be taxed as a U.S. corporation and pays U.S. tax at the 21% tax rate. The taxability of this entity does not represent a reconciling item between the U.S. federal rate and the Company's effective tax rate. This entity ceased to operate in 2025. (2) During the year ended December 31, 2024, state taxes in California, Florida and Illinois comprised greater than 50% of the tax effect in this category. During the year ended December 31, 2023, state taxes in California and Florida comprised greater than 50% of the tax effect in this category. During the year ended December 31, 2022, state taxes in California and Pennsylvania comprised greater than 50% of the tax effect in this category. Income taxes paid are as follows ($ in millions): Year Ended December 31, 2024 2023 2022 U.S. Federal (1) $ 930 $ 698 $ 1,009 Pennsylvania * 53 * Other (2) 71 138 175 Total U.S. State and Local 71 191 175 Foreign 1 (2) 14 Total income taxes paid, net $ 1,002 $ 887 $ 1,198 (1) Includes amounts paid to purchase transferable tax credits of $100 million and $49 million during the years ended December 31, 2024 and 2023, respectively. (2) Includes amounts paid to purchase transferable tax credits of $15 million, $10 million and $19 million during the years ended December 31, 2024, 2023 and 2022, respectively. * The amount of income taxes paid during the years ended December 31, 2024 and 2022 does not meet the 5% disaggregation threshold. The tax effects of temporary differences which give rise to deferred tax assets and liabilities are presented below ($ in millions): December 31, 2024 December 31, 2023 Deferred tax assets: Medical claims liability $ 178 $ 217 Nondeductible liabilities 81 111 Net operating loss and tax credit carryforwards 70 71 Compensation accruals 93 113 Premium and trade receivables 72 94 Operating lease liability 231 269 Unrealized gain/loss 153 179 Software development costs 246 193 Other 92 92 Deferred tax assets 1,216 1,339 Valuation allowance (77) (82) Net deferred tax assets $ 1,139 $ 1,257 Deferred tax liabilities: Goodwill and intangible assets $ 1,518 $ 1,603 Fixed assets 135 127 Right-of-use asset 88 98 Other 82 70 Deferred tax liabilities 1,823 1,898 Net deferred tax liabilities $ (684) $ (641) Valuation allowances are provided when it is considered more likely than not that deferred tax assets will not be realized. The valuation allowances primarily relate to future tax benefits on certain federal and state net operating loss, federal and state capital loss and tax credit carryforwards. Federal net operating loss and credit carryforwards of $11 million expire beginning in 2025 through 2042. State net operating loss and tax credit carryforwards of $42 million expire beginning in 2025 through 2043, while the remaining $16 million have indefinite carryforward periods. The Company maintains a reserve for uncertain tax positions that may be challenged by a tax authority. A rollforward of the beginning and ending amount of uncertain tax positions, exclusive of related interest and penalties, is as follows ($ in millions): Year Ended December 31, 2024 2023 Gross unrecognized tax benefits, January 1 $ 439 $ 410 Gross increases: Current year tax positions 16 19 Prior year tax positions 31 29 Gross decreases: Settlements (1) (133) (2) Prior year tax positions (6) (10) Statute of limitation lapses (7) (7) Gross unrecognized tax benefits, December 31 $ 340 $ 439 (1) Primarily reflects the resolution of an item that had no net impact on the Consolidated Statement of Operations. As of December 31, 2024, $213 million of unrecognized tax benefits would impact the Company's effective tax rate in future periods, if recognized. The table above excludes interest and penalties, net of related tax benefits, which are treated as income tax expense (benefit) under the Company's accounting policy. The Company recognized net interest expense and penalties related to uncertain positions of $13 million and $18 million for the years ended December 31, 2024 and 2023, respectively. The Company had $98 million and $84 million of accrued interest and penalties for uncertain tax positions as of December 31, 2024 and 2023, respectively. The Company files federal tax returns as well as returns for numerous state tax jurisdictions and is engaged in multiple audit proceedings for its state filings. Generally, no further state audit activity is expected for years prior to 2015. As of December 31, 2024, the Company is not under federal examination.

Stock Incentive Plans

Stock Incentive Plans	12 Months Ended
	Dec. 31, 2024
Share-Based Payment Arrangement [Abstract]
Stock Incentive Plans	Stock Incentive Plans The Company's stock incentive plans allow for the granting of restricted stock or restricted stock unit awards and options to purchase common stock. Both incentive stock options and nonqualified stock options can be awarded under the plans. However, an immaterial amount of options were granted, exercised or outstanding in 2024. The plans have 10 million shares available for future awards. Compensation expense for stock options and restricted stock unit awards is recognized on a straight-line basis over the vesting period, generally three one A summary of the Company's non-vested restricted stock and restricted stock unit shares as of December 31, 2024, and changes during the year ended December 31, 2024, is presented below (shares in thousands): Shares Weighted Average Non-vested balance, December 31, 2023 7,462 $ 68.96 Granted 3,741 76.84 Vested (4,196) 69.42 Forfeited (655) 70.88 Non-vested balance, December 31, 2024 6,352 $ 73.10 The total fair value of restricted stock and restricted stock units vested during the years ended December 31, 2024, 2023 and 2022, was $317 million, $185 million and $298 million, respectively. As of December 31, 2024, there was $223 million of total unrecognized compensation cost related to non-vested share-based compensation arrangements granted under the plans; that cost is expected to be recognized over a weighted-average period of 1.9 years.

Retirement Plan

Retirement Plan	12 Months Ended
	Dec. 31, 2024
Retirement Benefits [Abstract]
Retirement Plan	Retirement Plan

Contingencies

Contingencies	12 Months Ended
	Dec. 31, 2024
Commitments and Contingencies Disclosure [Abstract]
Contingencies	Contingencies The Company is routinely subjected to legal and regulatory proceedings in the normal course of business. These matters can include, without limitation: • periodic compliance and other reviews and investigations by various federal and state regulatory agencies with respect to requirements applicable to the Company's business, which could result in litigation, including, without limitation, those related to payment of out-of-network claims, compliance with CMS Medicare and Marketplace regulations, including risk adjustment and broker compensation, compliance with the False Claims Act, the calculation of minimum MLR and rebates related thereto, submissions to state agencies related to payments or state false claims acts, pre-authorization penalties, timely review of grievances and appeals, timely and accurate payment of claims, provider directory accuracy, cybersecurity issues, including those related to the Company's or the Company's third-party vendors' information systems, and the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and other federal and state fraud, waste and abuse laws; • litigation arising out of regulatory proceedings and general business activities, such as tax matters, disputes related to healthcare benefits coverage or reimbursement, putative securities class actions, and medical malpractice, privacy, real estate, intellectual property, vendor disputes and employment-related claims; and • disputes regarding reinsurance arrangements, claims arising out of the acquisition or divestiture of various assets, class actions, and claims relating to the performance of contractual and non-contractual obligations to providers, members, employer groups, third-party vendors and others, including, but not limited to, the alleged failure to properly pay claims and challenges to the manner in which the Company processes claims, claims related to network adequacy, provider directory accuracy and claims alleging that the Company has engaged in unfair business practices. Among other things, these matters may result in awards of damages, fines, or penalties, which could be substantial, and/or could require changes to the Company's business. The Company intends to vigorously defend itself against legal and regulatory proceedings to which it is currently a party; however, these proceedings are subject to many uncertainties. In some of the cases pending against the Company, substantial non-economic or punitive damages are being sought. The Company records reserves and accrues costs for certain legal proceedings and regulatory matters to the extent that it determines an unfavorable outcome is probable and the amount of the loss can be reasonably estimated. While such reserves and accrued costs reflect the Company's best estimate of the probable loss for such matters, the recorded amounts may differ materially from the actual amount of any such losses. In some cases, no estimate of the possible loss or range of loss in excess of amounts accrued, if any, can be made because of the inherently unpredictable nature of legal and regulatory proceedings, which may be exacerbated by various factors, including but not limited to, they may involve indeterminate claims for monetary damages or may involve fines, penalties or punitive damages; present novel legal theories or legal uncertainties; involve disputed facts; represent a shift in regulatory policy; involve a large number of parties, claimants or regulatory bodies; are in the early stages of the proceedings; involve a number of separate proceedings and/or a wide range of potential outcomes; or result in a change of business practices. As of the date of this report, amounts accrued for legal proceedings and regulatory matters were not material. It is possible that in a particular quarter or annual period the Company's financial condition, results of operations, cash flow, and/or liquidity could be materially adversely affected by an ultimate unfavorable resolution of or development in legal and/or regulatory proceedings. The Company believes that the ultimate outcome of any of the regulatory and legal proceedings that are currently pending against it should not have a material adverse effect on financial condition, results of operations, cash flow, or liquidity.

Earnings Per Share

Earnings Per Share	12 Months Ended
	Dec. 31, 2024
Earnings Per Share [Abstract]
Earnings Per Share	Earnings Per Share The following table sets forth the calculation of basic and diluted net earnings per common share ($ in millions, except per share data in dollars and shares in thousands): Year Ended December 31, 2024 2023 2022 Earnings attributable to Centene Corporation $ 3,305 $ 2,702 $ 1,202 Shares used in computing per share amounts: Weighted average number of common shares outstanding 521,790 543,319 575,191 Common stock equivalents (as determined by applying the treasury stock method) 1,954 2,385 6,849 Weighted average number of common shares and potential dilutive common shares outstanding 523,744 545,704 582,040 Net earnings per common share attributable to Centene Corporation: Basic earnings per common share $ 6.33 $ 4.97 $ 2.09 Diluted earnings per common share $ 6.31 $ 4.95 $ 2.07 The calculation of diluted earnings per common share for 2024, 2023 and 2022 excludes the impact of 278 thousand shares, 376 thousand shares and 187 thousand shares, respectively, related to anti-dilutive stock options and restricted stock units.

Segment Information

Segment Information	12 Months Ended
	Dec. 31, 2024
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, Envolve Benefit Options' vision and dental services, clinical healthcare, behavioral health, international operations and corporate management company, among others. The Company's international businesses, Operose Health and Circle Health, which were included in the Other segment, were divested in December 2023 and January 2024, respectively. 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 year ended December 31, 2024, is as follows ($ in millions): Medicaid Medicare Commercial Other/Eliminations Consolidated Total Premium $ 83,758 $ 23,032 $ 33,699 $ 1,814 $ 142,303 Service 93 — 3 3,106 3,202 Premium and service revenues 83,851 23,032 33,702 4,920 145,505 Premium tax 17,566 — — — 17,566 Total external revenues 101,417 23,032 33,702 4,920 163,071 Internal revenues — — — 16,879 16,879 Eliminations — — — (16,879) (16,879) Total revenues $ 101,417 $ 23,032 $ 33,702 $ 4,920 $ 163,071 Medical costs $ 77,516 $ 20,437 $ 26,039 $ 1,715 $ 125,707 Cost of services 89 — — 2,640 2,729 Other operating expenses (1) 31,460 Other income (expense) (2) 1,082 Earnings before income tax expense $ 4,257 Segment gross margin (3) $ 6,246 $ 2,595 $ 7,663 $ 565 $ 17,069 (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 year ended December 31, 2023, is as follows ($ in millions): Medicaid Medicare Commercial Other/Eliminations Consolidated Total Premium $ 86,853 $ 22,261 $ 24,843 $ 1,679 $ 135,636 Service 2 — 2 4,455 4,459 Premium and service revenues 86,855 22,261 24,845 6,134 140,095 Premium tax 13,904 — — — 13,904 Total external revenues 100,759 22,261 24,845 6,134 153,999 Internal revenues — — — 16,735 16,735 Eliminations — — — (16,735) (16,735) Total revenues $ 100,759 $ 22,261 $ 24,845 $ 6,134 $ 153,999 Medical costs $ 78,210 $ 19,394 $ 19,816 $ 1,474 $ 118,894 Cost of services 4 — — 3,560 3,564 Other operating expenses (1) 28,611 Other income (expense) (2) 668 Earnings before income tax expense $ 3,598 Segment gross margin (3) $ 8,641 $ 2,867 $ 5,029 $ 1,100 $ 17,637 (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 year ended December 31, 2022, is as follows ($ in millions): Medicaid Medicare Commercial Other/Eliminations Consolidated Total Premium $ 84,084 $ 22,484 $ 17,377 $ 3,186 $ 127,131 Service (1) — 3 8,346 8,348 Premium and service revenues 84,083 22,484 17,380 11,532 135,479 Premium tax 9,068 — — — 9,068 Total external revenues 93,151 22,484 17,380 11,532 144,547 Internal revenues — — — 25,191 25,191 Eliminations — — — (25,191) (25,191) Total revenues $ 93,151 $ 22,484 $ 17,380 $ 11,532 $ 144,547 Medical costs $ 75,298 $ 19,372 $ 14,092 $ 2,767 $ 111,529 Cost of services — — — 7,032 7,032 Other operating expenses (1) 24,668 Other income (expense) (2) 644 Earnings before income tax expense $ 1,962 Segment gross margin (3) $ 8,785 $ 3,112 $ 3,288 $ 1,733 $ 16,918 (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.

Condensed Financial Information

Condensed Financial Information of Registrant	12 Months Ended
	Dec. 31, 2024
Condensed Financial Information Disclosure [Abstract]
Condensed Financial Information of Registrant	Condensed Financial Information of Registrant Centene Corporation (Parent Company Only) Condensed Balance Sheets (In millions, except shares in thousands and per share data in dollars) December 31, 2024 December 31, 2023 ASSETS Current assets: Cash and cash equivalents $ 7 $ 7 Other current assets 9 7 Total current assets 16 14 Long-term investments 206 264 Investment in subsidiaries 45,148 43,853 Other long-term assets 85 186 Total assets $ 45,455 $ 44,317 LIABILITIES, REDEEMABLE NONCONTROLLING INTERESTS AND STOCKHOLDERS' EQUITY Current liabilities: Current liabilities $ 243 $ 417 Current portion of long-term debt 110 110 Total current liabilities 353 527 Long-term debt 18,423 17,708 Other long-term liabilities 169 126 Total liabilities 18,945 18,361 Commitments and contingencies Redeemable noncontrolling interest 10 19 Stockholders' equity: Preferred stock, $0.001 par value; authorized 10,000 shares; no shares issued or outstanding at December 31, 2024 and December 31, 2023 — — Common stock, $0.001 par value; authorized 800,000 shares; 620,195 issued and 495,907 outstanding at December 31, 2024, and 615,291 issued and 534,484 outstanding at December 31, 2023 1 1 Additional paid-in capital 20,562 20,304 Accumulated other comprehensive (loss) (504) (652) Retained earnings 15,348 12,043 Treasury stock, at cost (124,288 and 80,807 shares, respectively) (8,997) (5,856) Total Centene stockholders' equity 26,410 25,840 Nonredeemable noncontrolling interest 90 97 Total stockholders' equity 26,500 25,937 Total liabilities, redeemable noncontrolling interests and stockholders' equity $ 45,455 $ 44,317 See notes to condensed financial information of registrant. Centene Corporation (Parent Company Only) Condensed Statements of Operations (In millions, except per share data in dollars) Year Ended December 31, 2024 2023 2022 Expenses: Selling, general and administrative expenses $ 13 $ 14 $ 21 Legal settlement — — 33 Other income (expense): Investment and other income (34) (47) 55 Gain (loss) on divestiture (34) 108 13 Debt extinguishment — — 14 Interest expense (700) (710) (643) (Loss) before income taxes (781) (663) (615) Income tax (benefit) (76) (118) (208) Net (loss) before equity in subsidiaries (705) (545) (407) Equity in earnings from subsidiaries 3,999 3,244 1,609 Net earnings 3,294 2,699 1,202 Loss attributable to noncontrolling interests 11 3 — Net earnings attributable to Centene Corporation $ 3,305 $ 2,702 $ 1,202 Net earnings per common share attributable to Centene Corporation: Basic earnings per common share $ 6.33 $ 4.97 $ 2.09 Diluted earnings per common share $ 6.31 $ 4.95 $ 2.07 See notes to condensed financial information of registrant. Centene Corporation (Parent Company Only) Condensed Statements of Cash Flows (In millions) Year Ended December 31, 2024 2023 2022 Cash flows from operating activities: Dividends from subsidiaries, return on investment $ 1,797 $ 2,823 $ 1,706 Payments for legal settlement (263) (326) (282) Other operating activities, net (422) (334) (450) Net cash provided by operating activities 1,112 2,163 974 Cash flows from investing activities: Capital contributions to subsidiaries (730) (443) (880) Purchases of investments (2) (202) (2) Dividends from subsidiaries, return of investment 321 85 10 Investments in acquisitions — — (2,431) Proceeds from divestitures — 325 — Intercompany activities 1,693 (357) 5,785 Other investing activities, net — — 3 Net cash (used in) provided by investing activities 1,282 (592) 2,485 Cash flows from financing activities: Proceeds from common stock issuances 46 44 70 Proceeds from long-term debt 1,300 2,305 75 Payments and repurchases of long-term debt (610) (2,290) (491) Common stock repurchases (3,124) (1,633) (3,096) Payments for debt extinguishment — — (14) Other financing activities, net (6) (2) — Net cash used in financing activities (2,394) (1,576) (3,456) Net increase (decrease) in cash and cash equivalents — (5) 3 Cash and cash equivalents, beginning of period 7 12 9 Cash and cash equivalents, end of period $ 7 $ 7 $ 12 See notes to condensed financial information of registrant. Notes to Condensed Financial Information of Registrant Note A - Basis of Presentation and Significant Accounting Policies The parent company only financial statements should be read in conjunction with Centene Corporation's audited consolidated financial statements and the notes to consolidated financial statements included in this Form 10-K. The parent company's investment in subsidiaries is stated at cost plus equity in undistributed earnings of the subsidiaries. The parent company's share of net income of its unconsolidated subsidiaries is included in income using the equity method of accounting. Certain unrestricted subsidiaries receive monthly management fees from the Company's restricted subsidiaries. The management and service fees received by its unrestricted subsidiaries are associated with all of the functions required to manage the restricted subsidiaries including, but not limited to, salaries and wages for personnel, rent, utilities, population health management, provider contracting, compliance, member services, claims processing, information technology, cash management, finance and accounting and other services. Beginning in 2023, the management fees are based on a cost basis reimbursement. Due to the Company's centralized cash management function, cash flows generated by its unrestricted subsidiaries are utilized by the parent company to the extent required, primarily to repay borrowings on the parent company's credit facilities, repurchase the parent company's common stock, make acquisitions, fund capital contributions to subsidiaries and fund its operations. Certain amounts presented in the parent company only financial statements are eliminated in the consolidated financial statements of Centene Corporation.

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Pay vs Performance Disclosure
Net earnings	$ 3,305	$ 2,702	$ 1,202

Insider Trading Arrangements

Insider Trading Arrangements	3 Months Ended
	Dec. 31, 2024
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false

Insider Trading Policies and Pr

Insider Trading Policies and Procedures	12 Months Ended
	Dec. 31, 2024
Insider Trading Policies and Procedures [Line Items]
Insider Trading Policies and Procedures Adopted	true

Cybersecurity Risk Management a

Cybersecurity Risk Management and Strategy Disclosure	12 Months Ended
	Dec. 31, 2024
Cybersecurity Risk Management, Strategy, and Governance [Line Items]
Cybersecurity Risk Management Processes for Assessing, Identifying, and Managing Threats [Text Block]	Our cybersecurity risk management and privacy programs play a central role in the protection of the confidential information of our members, team members, and business partners, and, as such, are critical to the successful operation of our business. Our cybersecurity risk management program is part of our enterprise-wide risk management practices. Based on the National Institute of Standards and Technology (NIST) Cybersecurity Framework, the program utilizes policies, processes, and technologies to assess, identify, and manage the cybersecurity threats that we face. Specifically, we use these policies, processes and technologies to identify internal and external threats, establish access control, data privacy and security measures, detect unauthorized activity, and respond to and recover from incidents. For example, we leverage external experts and our internal threat and risk teams to assess potential threats, retain external consultants to conduct penetration tests and health checks on our information systems, conduct cyber security and awareness training to help team members identify and manage common categories of cybersecurity threats, utilize multiple protective and detective tools to identify active threats and have a 24/7 Security Operations Center to manage incident response. Our cybersecurity risk management program also includes processes and controls to assess the cybersecurity risk associated with third-party vendors and partners. Following an initial assessment of the level of enterprise risk potentially posed by use of the third-party, the vendor is then subject to further risk-based assessments, the level of which depends upon the assigned risk value of the service being provided, which may include the completion of security questionnaires and the provision of independent security certifications. On a bi-annual schedule, we use an external firm to assess our cybersecurity risk management program using the Capability Maturity Model Integration (CMMI) process and behavioral model. In addition, elements of the program are subject to Service Organization Control Type 2 (SOC 2) and ISO 27001 audits by a third party.
Cybersecurity Risk Management Processes Integrated [Flag]	true
Cybersecurity Risk Management Processes Integrated [Text Block]	Our cybersecurity risk management and privacy programs play a central role in the protection of the confidential information of our members, team members, and business partners, and, as such, are critical to the successful operation of our business. Our cybersecurity risk management program is part of our enterprise-wide risk management practices. Based on the National Institute of Standards and Technology (NIST) Cybersecurity Framework, the program utilizes policies, processes, and technologies to assess, identify, and manage the cybersecurity threats that we face. Specifically, we use these policies, processes and technologies to identify internal and external threats, establish access control, data privacy and security measures, detect unauthorized activity, and respond to and recover from incidents. For example, we leverage external experts and our internal threat and risk teams to assess potential threats, retain external consultants to conduct penetration tests and health checks on our information systems, conduct cyber security and awareness training to help team members identify and manage common categories of cybersecurity threats, utilize multiple protective and detective tools to identify active threats and have a 24/7 Security Operations Center to manage incident response. Our cybersecurity risk management program also includes processes and controls to assess the cybersecurity risk associated with third-party vendors and partners. Following an initial assessment of the level of enterprise risk potentially posed by use of the third-party, the vendor is then subject to further risk-based assessments, the level of which depends upon the assigned risk value of the service being provided, which may include the completion of security questionnaires and the provision of independent security certifications. On a bi-annual schedule, we use an external firm to assess our cybersecurity risk management program using the Capability Maturity Model Integration (CMMI) process and behavioral model. In addition, elements of the program are subject to Service Organization Control Type 2 (SOC 2) and ISO 27001 audits by a third party.
Cybersecurity Risk Management Third Party Engaged [Flag]	true
Cybersecurity Risk Third Party Oversight and Identification Processes [Flag]	true
Cybersecurity Risk Materially Affected or Reasonably Likely to Materially Affect Registrant [Flag]	false
Cybersecurity Risk Board of Directors Oversight [Text Block]	Our Board of Directors has primary responsibility for the oversight of our enterprise-wide risk management and exercises its oversight function in respect of cybersecurity risk through two of its committees. Specifically, our Board Audit and Compliance Committee has oversight responsibility for the Company's enterprise risk management process, including the Company's programs to identify, manage, respond to and mitigate the Company's IT risks, including risks related to cybersecurity, artificial intelligence, privacy, critical infrastructure assets and disaster recovery, as well as identifying the potential likelihood, frequency and severity of cyberattacks and breaches. Our Board Quality Committee has oversight responsibility for overall data and technology strategy. Each committee reports to the full Board on a regular basis. The oversight responsibility of our Board of Directors and its committees is facilitated through quarterly management-reporting processes designed to provide visibility to the Board and its committees on the processes for the identification, assessment, prioritization and management of critical risks and management's risk mitigation strategies. Such reporting includes providing regular updates to the Board Audit and Compliance Committee regarding the evolving cybersecurity threat environment, updates to our cybersecurity risk management program to address and mitigate such threats and providing quarterly reports to the Quality Committee on the Company's execution of its data and technology strategy. Management also escalates significant cybersecurity events to the Audit and Compliance Committee and the Board on a real time basis, as appropriate. Further, our Board also receives enterprise-wide risk management reports, which include significant cybersecurity risks, from our risk department multiple times per year. In addition, our Board and management have conducted tabletop cybersecurity crisis simulation exercises.
Cybersecurity Risk Board Committee or Subcommittee Responsible for Oversight [Text Block]	The oversight responsibility of our Board of Directors and its committees is facilitated through quarterly management-reporting processes designed to provide visibility to the Board and its committees on the processes for the identification, assessment, prioritization and management of critical risks and management's risk mitigation strategies.
Cybersecurity Risk Process for Informing Board Committee or Subcommittee Responsible for Oversight [Text Block]	The oversight responsibility of our Board of Directors and its committees is facilitated through quarterly management-reporting processes designed to provide visibility to the Board and its committees on the processes for the identification, assessment, prioritization and management of critical risks and management's risk mitigation strategies. Such reporting includes providing regular updates to the Board Audit and Compliance Committee regarding the evolving cybersecurity threat environment, updates to our cybersecurity risk management program to address and mitigate such threats and providing quarterly reports to the Quality Committee on the Company's execution of its data and technology strategy. Management also escalates significant cybersecurity events to the Audit and Compliance Committee and the Board on a real time basis, as appropriate. Further, our Board also receives enterprise-wide risk management reports, which include significant cybersecurity risks, from our risk department multiple times per year. In addition, our Board and management have conducted tabletop cybersecurity crisis simulation exercises.
Cybersecurity Risk Role of Management [Text Block]	While our Board of Directors has overall responsibility for the oversight of our enterprise-wide risk management, of which cybersecurity risk management is one component, our management team is responsible for day-to-day risk management, including the implementation of our cybersecurity risk management program. Our enterprise risk management committee, which operates within our risk department and comprises certain of our senior leaders including operations, finance, information technology, government relations, legal, marketing, health plan leadership, health operations, and communications meets at least four times per year to discuss significant risks to the Company identified by our enterprise-wide risk management process, including cybersecurity risks identified by our cybersecurity risk management program. The enterprise risk management committee also discusses the steps management has taken to identify, monitor, assess, and control or avoid such exposures and reviews performance measures against the Company's risk appetite and tolerance and provides recommendations of corrective action where appropriate. At an operational level, our Chief Security and Privacy Officer (CSPO) and our Chief Information Security Officer (CISO) lead the management of our cybersecurity risk management program. Our CSPO is responsible for overseeing the day-to-day operation of our cybersecurity risk management program, including reporting systemic cybersecurity risk matters to our senior management and, as appropriate, to the Board of Directors. Our CISO oversees our cybersecurity operations, including all identity and access management functions, cybersecurity incident response operations and the effective operation of the suite of security tools we employ. The CISO and CSPO track key cybersecurity metrics across the enterprise, including metrics related to threat and vulnerability management, cybersecurity incidents and asset management and protection. Our CISO reports the status and efficacy of our cybersecurity operations to our senior management and, as appropriate, to the Board of Directors. Using our cybersecurity incident response plan, each incident receives a severity rating using a scale approved by management. Based on that rating, we employ an escalation matrix that provides appropriate notifications to management, as well as to our Board of Directors. The cybersecurity incident response plan is integrated into our overall crisis management plan and process, for which our CSPO has ultimate day-to-day responsibility. Our CSPO and CISO share joint responsibility for providing regular cybersecurity updates to our Audit and Compliance Committee, including updates on our key technology initiatives, including those involving cybersecurity, and their status. Our CSPO, CISO and other dedicated cybersecurity risk management personnel are certified and experienced information systems security professionals and information security managers. Our CSPO has over 30 years of experience in information security having 16 years of experience leading information security programs and obtained the Certified Information Systems Security Professional certification from ISC2. Our CISO, who has over 34 years of experience in cyber operations, communications, crisis management and command and control, holds multiple graduate degrees, obtained the Certified Information Systems Security Professional certification from ISC2 and holds the Qualified Technical Expert certification from the Digital Director's Network.
Cybersecurity Risk Management Positions or Committees Responsible [Flag]	true
Cybersecurity Risk Management Positions or Committees Responsible [Text Block]	Our enterprise risk management committee, which operates within our risk department and comprises certain of our senior leaders including operations, finance, information technology, government relations, legal, marketing, health plan leadership, health operations, and communications meets at least four times per year to discuss significant risks to the Company identified by our enterprise-wide risk management process, including cybersecurity risks identified by our cybersecurity risk management program. The enterprise risk management committee also discusses the steps management has taken to identify, monitor, assess, and control or avoid such exposures and reviews performance measures against the Company's risk appetite and tolerance and provides recommendations of corrective action where appropriate. At an operational level, our Chief Security and Privacy Officer (CSPO) and our Chief Information Security Officer (CISO) lead the management of our cybersecurity risk management program.
Cybersecurity Risk Management Expertise of Management Responsible [Text Block]	Our CSPO, CISO and other dedicated cybersecurity risk management personnel are certified and experienced information systems security professionals and information security managers. Our CSPO has over 30 years of experience in information security having 16 years of experience leading information security programs and obtained the Certified Information Systems Security Professional certification from ISC2. Our CISO, who has over 34 years of experience in cyber operations, communications, crisis management and command and control, holds multiple graduate degrees, obtained the Certified Information Systems Security Professional certification from ISC2 and holds the Qualified Technical Expert certification from the Digital Director's Network.
Cybersecurity Risk Process for Informing Management or Committees Responsible [Text Block]	Our CSPO is responsible for overseeing the day-to-day operation of our cybersecurity risk management program, including reporting systemic cybersecurity risk matters to our senior management and, as appropriate, to the Board of Directors. Our CISO oversees our cybersecurity operations, including all identity and access management functions, cybersecurity incident response operations and the effective operation of the suite of security tools we employ. The CISO and CSPO track key cybersecurity metrics across the enterprise, including metrics related to threat and vulnerability management, cybersecurity incidents and asset management and protection. Our CISO reports the status and efficacy of our cybersecurity operations to our senior management and, as appropriate, to the Board of Directors. Using our cybersecurity incident response plan, each incident receives a severity rating using a scale approved by management. Based on that rating, we employ an escalation matrix that provides appropriate notifications to management, as well as to our Board of Directors. The cybersecurity incident response plan is integrated into our overall crisis management plan and process, for which our CSPO has ultimate day-to-day responsibility. Our CSPO and CISO share joint responsibility for providing regular cybersecurity updates to our Audit and Compliance Committee, including updates on our key technology initiatives, including those involving cybersecurity, and their status.
Cybersecurity Risk Management Positions or Committees Responsible Report to Board [Flag]	true

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	12 Months Ended
	Dec. 31, 2024
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation The accompanying consolidated financial statements include the accounts of Centene Corporation and all majority owned subsidiaries and subsidiaries over which the Company exercises the power and control to direct activities significantly impacting financial performance. All material intercompany balances and transactions have been eliminated. Certain 2022 and 2023 amounts in the consolidated financial statements and notes to the consolidated financial statements have been reclassified to conform to the 2024 presentation. These reclassifications have no effect on net earnings or stockholders' equity as previously reported. During 2024, the Company completed the divestitures of Circle Health and Collaborative Health Systems (CHS). See Note 3. Acquisitions and Divestitures for further details.
Use of Estimates	Use of Estimates
Business Combinations	Business Combinations Business combinations are accounted for using the acquisition method of accounting. The Company allocates the fair value of purchase consideration to the assets acquired and liabilities assumed based on their fair values at the acquisition date. The excess of the fair value of consideration transferred over the fair value of the net assets acquired is recorded as goodwill. Goodwill is generally attributable to the value of the synergies between the combined companies and the value of the acquired assembled workforce, neither of which qualifies for recognition as an intangible asset. The Company uses its best estimates and assumptions to value assets acquired and liabilities assumed at the acquisition date; however, these estimates are sometimes preliminary and, in some instances, all information required to value the assets acquired and liabilities assumed may not be available or final as of the end of a reporting period subsequent to the business combination. If the accounting for the business combination is incomplete, provisional amounts are recorded. The provisional amounts are updated during the period determined, up to one year from the acquisition date. The Company includes the results of operations of acquired businesses in the Company's consolidated results prospectively from the date of acquisition. Acquisition related expenses and post-acquisition restructuring costs are recognized separately from the business combination and are expensed as incurred.
Cash and Cash Equivalents	Cash and Cash Equivalents Investments with original maturities of three months or less are considered to be cash equivalents. Cash equivalents consist of money market funds, bank certificates of deposit and savings accounts. The Company maintains amounts on deposit with various financial institutions, which may exceed federally insured limits. However, management periodically evaluates the credit-worthiness of those institutions, and the Company has not experienced any losses on such deposits.
Investments	Investments Short-term investments include securities with maturities greater than three months to one year. Long-term investments include securities with maturities greater than one year. Short-term and long-term investments are generally classified as available-for-sale and are carried at fair value. Certain equity investments are recorded using the fair value or equity method. The Company monitors the difference between the carrying value and fair value of its available-for-sale debt investments and whether declines in fair value are credit related. Unrealized gains and losses on debt investments available-for-sale are excluded from earnings and reported in accumulated other comprehensive earnings (loss), a separate component of stockholders' equity, net of income tax effects. If a loss is deemed to be credit related, the Company recognizes an allowance through earnings. For each security in an unrealized loss position, the Company assesses whether it intends to sell the security or if it is more likely than not the Company will be required to sell the security before recovery of the amortized cost basis for reasons such as liquidity, contractual or regulatory purposes. If the security meets this criterion, the decline in fair value is recorded in earnings through investment and other income. Premiums and discounts are amortized or accreted over the life of the related security using the effective interest method. To calculate realized gains and losses on the sale of investments, the Company uses the specific amortized cost of each investment sold. Realized gains and losses are recorded in investment and other income.
Restricted Deposits	Restricted Deposits Restricted deposits consist of investments required by various state statutes to be deposited or pledged to state agencies. These investments are classified as long-term, regardless of the contractual maturity date, due to the nature of the states' requirements. The Company is required to annually adjust the amount of the deposit pledged to certain states.
Fair Value Measurements	Fair Value Measurements In the normal course of business, the Company invests in various financial assets and incurs various financial liabilities. Fair values are disclosed for all financial instruments, whether or not such values are recognized in the Consolidated Balance Sheets. Management obtains quoted market prices and other observable inputs for these disclosures. The carrying amounts reported in the Consolidated Balance Sheets for cash and cash equivalents, premium and trade receivables, medical claims liability, accounts payable and accrued expenses, unearned revenue and certain other current assets and liabilities are carried at cost, which approximates fair value because of their short-term nature. The following methods and assumptions were used to estimate the fair value of each financial instrument: • Available-for-sale investments and restricted deposits: The carrying amount is stated at fair value, based on quoted market prices, where available. For securities not actively traded, fair values were estimated using values obtained from independent pricing services or quoted market prices of comparable instruments. • Senior unsecured notes: Estimated based on third-party quoted market prices for the same or similar issues. • Variable rate debt: The carrying amount of the Company's floating rate debt approximates fair value since the interest rates adjust based on market rate adjustments. • Contingent consideration: Estimated based on expected achievement of metrics included in the acquisition agreement considering circumstances that exist as of the acquisition date.
Property, Software and Equipment	Property, Software and Equipment Property, software and equipment are stated at cost less accumulated depreciation. Computer hardware and software includes certain costs incurred in the development of internal-use software, including external direct costs of materials and services and payroll costs of team members devoted to specific software development. Depreciation is calculated principally by the straight-line method over estimated useful lives. Leasehold improvements are depreciated using the straight-line method over the shorter of the expected useful life or the remaining term of the lease. Property, software and equipment are depreciated over the following periods: Fixed Asset Depreciation Period Buildings and improvements 10 - 40 years Computer hardware and software 3 - 5 years Furniture and equipment 5 - 10 years Land improvements 10 - 25 years Leasehold improvements 1 - 20 years The carrying amounts of all long-lived assets are evaluated to determine if adjustment to the depreciation and amortization period or to the unamortized balance is warranted. Such evaluation is based principally on the expected utilization of the long-lived assets.
Goodwill and Intangible Assets	Goodwill and Intangible Assets Intangible assets represent assets acquired in purchase transactions and consist primarily of purchased contract rights and customer relationships, provider contracts, trade names, developed technologies and goodwill. Intangible assets are amortized using the straight-line method over the following periods: Intangible Asset Amortization Period Purchased contract rights and customer relationships 3 - 21 years Provider contracts 4 - 15 years Trade names 7 - 20 years Developed technologies 2 - 7 years The Company tests for impairment of intangible assets, as well as long-lived assets, whenever events or circumstances indicate that the carrying value of an asset or asset group (hereinafter referred to as "asset group") may not be recoverable by comparing the sum of the estimated undiscounted future cash flows expected to result from use of the asset group and its eventual disposition to the carrying value. Such factors include significant changes in membership, financial performance, state funding, government contracts and provider networks and contracts. If the sum of the estimated undiscounted future cash flows is less than the carrying value, an impairment determination is required. The amount of impairment is calculated by subtracting the fair value of the asset group from the carrying value of the asset group. An impairment charge, if any, is recognized within earnings from operations. The Company operates in four segments: (1) a Medicaid segment, (2) a Medicare segment, (3) a Commercial segment and (4) an Other segment. The Company defines its reporting units as its operating segments or one level below the operating segment. The Company tests goodwill for impairment at the reporting unit level using a fair value approach. The Company is required to test for impairment at least annually, absent a triggering event, which could include a significant decline in operating performance that would require an impairment assessment. Absent any impairment indicators, the Company performs its goodwill impairment testing during the fourth quarter of each year. The Company recognizes an impairment charge for any amount by which the carrying amount of goodwill exceeds its fair value. The Company first assesses qualitative factors to determine whether it is necessary to perform the quantitative goodwill impairment test. The Company generally does not calculate the fair value of a reporting unit unless it determines, based on a qualitative assessment, that it is more likely than not that its fair value is less than its carrying amount. If the quantitative test is deemed necessary, the Company determines an appropriate valuation technique to estimate a reporting unit's fair value as of the testing date. The Company utilizes either the income approach or the market approach, whichever is most appropriate for the respective reporting unit. The income approach is based on an internally developed discounted cash flow model that includes assumptions related to future growth rates, discount factors, future tax rates and other various assumptions. The market approach is based on financial multiples of comparable companies derived from current market data. The Company then compares the fair value of the reporting unit calculated using the income approach or market approach with its carrying amount and recognizes an impairment charge for the amount by which the carrying amount exceeds fair value. The impairment charge is limited to the total amount of goodwill allocated to the reporting unit. Changes in economic and operating conditions impacting assumptions used in the Company's analyses could result in goodwill impairment in future periods.
Medical Claims Liability	Medical Claims Liability Medical claims liability includes claims reported but not yet paid, or claims inventory, estimates for claims incurred but not reported, or IBNR, and estimates for the costs necessary to process unpaid claims at the end of each period. The Company estimates its medical claims liability using actuarial methods that are commonly used by health insurance actuaries and meet Actuarial Standards of Practice. These actuarial methods consider factors such as historical data for payment patterns, cost trends, product mix, seasonality, utilization of healthcare services and other relevant factors. Actuarial Standards of Practice generally require that the medical claims liability estimates be adequate to cover obligations under moderately adverse conditions. Moderately adverse conditions are situations in which the actual claims are expected to be higher than the otherwise estimated value of such claims at the time of estimate. The claims amounts ultimately settled will most likely be different than the estimate that satisfies the Actuarial Standards of Practice. The Company includes in its IBNR an estimate for medical claims liability under moderately adverse conditions which represents the risk of adverse deviation of the estimates in its actuarial method of reserving. The Company uses its judgment to determine the assumptions to be used in the calculation of the required estimates. The assumptions it considers when estimating IBNR include, without limitation, claims receipt and payment experience (and variations in that experience), changes in membership, provider billing practices, healthcare service utilization trends, cost trends, product mix, seasonality, prior authorization of medical services, benefit changes, known outbreaks of disease or increased incidence of illness such as influenza, provider contract changes, changes to fee schedules and the incidence of high-dollar or catastrophic claims. The Company's development of the medical claims liability estimate is a continuous process which it monitors and refines on a monthly basis as additional claims receipts and payment information becomes available. As more complete claims information becomes available, the Company adjusts the amount of the estimates, and includes the changes in estimates in medical costs in the period in which the changes are identified. In every reporting period, the operating results include the effects of more completely developed medical claims liability estimates associated with previously reported periods. The Company consistently applies its reserving methodology from period to period. As additional information becomes known, it adjusts the actuarial models accordingly to establish medical claims liability estimates. The Company reviews actual and anticipated experience compared to the assumptions used to establish medical costs. The Company establishes premium deficiency reserves if actual and anticipated experience indicates that existing policy liabilities together with the present value of future gross premiums will not be sufficient to cover the present value of future benefits, settlement and maintenance costs. For purposes of determining premium deficiencies, contracts are grouped in a manner consistent with the method of acquiring, servicing and measuring the profitability of such contracts and expected investment income is excluded. In December 2023, the Company recorded a premium deficiency reserve of $250 million related to the 2024 Medicare Advantage contract year. In December 2024, the Company recorded a premium deficiency reserve of $92 million related to the 2025 Medicare Advantage contract year.
Revenue Recognition	Revenue Recognition The Company's health plans generate revenues primarily from premiums received from the states in which it operates health plans, premiums received from its members and the Centers for Medicare and Medicaid Services (CMS) for its Medicare product and premiums from members of its commercial health plans. In addition to member premium payments, its Marketplace contracts also generate revenues from subsidies received from CMS. The Company generally receives a fixed premium per member per month pursuant to its contracts and recognizes premium revenues during the period in which it is obligated to provide services to its members at the amount reasonably estimable. In some instances, the Company's base premiums are subject to an adjustment, in the form of a risk score or risk adjustment, based on the acuity of its membership. Generally, the risk score or risk adjustment is determined by the state or CMS analyzing submissions of processed claims and medical record data to determine the acuity of the Company's membership, often relative to the respective program's membership. The Company estimates the amount of risk score and risk adjustment based upon the processed claims and medical record data submitted and expected to be submitted to the state or CMS and records revenues on a risk adjusted basis. Some contracts allow for additional premiums related to certain supplemental services provided such as maternity deliveries. The Company's contracts with states and CMS may require it to maintain a minimum medical loss ratio (MLR) or may require it to share cost-savings in excess of certain levels. In certain circumstances, including commercial plans, its plans may be required to return premium to the state or policyholders in the event costs are below established levels. The Company estimates the effect of these programs and recognizes reductions in revenue in the current period. Other states may require us to meet certain performance and quality metrics in order to receive additional or full contractual revenue. For performance-based contracts, the Company does not recognize revenue subject to refund until data is sufficient to measure performance. Revenues are recorded based on membership and eligibility data provided by the states or CMS, which is adjusted on a monthly basis by the states or CMS for retroactive additions or deletions to membership data. These eligibility adjustments are estimated monthly and subsequent adjustments are made in the period known. The Company reviews and updates those estimates as new information becomes available. It is possible that new information could require us to make additional adjustments, which could be significant, to these estimates. The Company's Medicare Advantage contracts are with CMS. CMS deploys a risk adjustment model which apportions premiums paid to all health plans according to health severity and certain demographic factors. The CMS risk adjustment model pays more for members whose medical history would indicate that they are expected to have higher medical costs. Under this risk adjustment methodology, CMS calculates the risk adjusted premium payment using diagnosis data from hospital inpatient, hospital outpatient, physician treatment settings as well as prescription drug events. The Company and the healthcare providers collect, compile and submit the necessary and available diagnosis data to CMS within prescribed deadlines. The Company estimates risk adjustment revenues based upon the diagnosis data submitted and expected to be submitted to CMS and records revenues on a risk adjusted basis. For qualifying low-income prescription drug benefit members, CMS pays for some, or all, of the member's monthly premium. The Company receives certain Part D prospective subsidy payments from CMS for these members as a fixed monthly per member amount, based on the estimated costs of providing prescription drug benefits over the plan year, as reflected in its bids. Approximately nine to ten months subsequent to the end of the plan year, or later in the case of the coverage gap discount subsidy, a settlement payment is made between CMS and the Company's plans based on the difference between the prospective payments and actual claims experience. The Company's specialty companies generate revenues under contracts with state and federal programs, healthcare organizations and other commercial organizations, as well as from its own subsidiaries. Revenues are recognized when the related services are provided, when inventory is shipped, or as ratably earned over the covered period of services. For performance-based measures in the Company's contracts, revenue is recognized as data sufficient to measure performance is available. The Company recognizes revenue related to administrative services under the TRICARE government-sponsored Managed Care Support Contract for the Department of Defense (DoD's) TRICARE program on a straight-line basis over the option period, when the fees become fixed and determinable. The TRICARE contract includes various performance-based measures. For each of the measures, an estimate of the amount that has been earned is made at each interim date, and revenue is recognized accordingly. The Company concluded serving members at the end of 2024 upon the expiration of its TRICARE Managed Care Support Contract. Some states enact premium taxes, similar assessments and provider pass-through payments, collectively premium taxes, and these taxes are recorded as a separate component of both revenues and operating expenses. For certain products, premium taxes and state assessments are not pass-through payments and are recorded as premium revenue and premium tax expense in the Consolidated Statements of Operations.
Affordable Care Act	Affordable Care Act The Affordable Care Act (ACA) established risk spreading premium stabilization programs as well as minimum MLR and cost sharing reductions (CSRs). The Company's accounting policies for the programs are as follows: Risk Adjustment The permanent risk adjustment program established by the ACA transfers funds from qualified individual and small group insurance plans with below average risk scores to those plans with above average risk scores within each state. The Company estimates the receivable or payable under the risk adjustment program based on its estimated risk score compared to the state average risk score. The Company may record a receivable or payable as an adjustment to premium revenues to reflect the year-to-date impact of the risk adjustment based on its best estimate. The Company refines its estimate as new information becomes available. Minimum Medical Loss Ratio Additionally, the ACA established a minimum MLR for the Health Insurance Marketplace. The risk adjustment program described above is taken into consideration to determine if the Company's estimated annual medical costs are less than the minimum MLR and require an adjustment to premium revenues to meet the minimum MLR. Cost Sharing Reductions
Premium and Trade Receivables and Unearned Revenue	Premium and Trade Receivables and Unearned Revenue Premium and service revenues collected in advance are recorded as unearned revenue. For performance-based contracts, the Company does not recognize revenue subject to refund until data is sufficient to measure performance. Premiums and service revenues due to the Company are recorded as premium and trade receivables and are recorded net of an allowance based on historical trends and management's judgment on the collectability of these accounts. As the Company generally receives payments during the month in which services are provided, the allowance is typically not significant in comparison to total revenues and does not have a material impact on the presentation of the financial condition or results of operations. Amounts receivable under federal contracts are comprised primarily of contractually defined billings, accrued contract incentives under the terms of the contract and amounts related to change orders for services not originally specified in the contract.
Significant Customers	Significant Customers The Company receives the majority of its revenues under contracts or subcontracts with state Medicaid managed care programs. None of the Company's customers exceeded 10% of total annual revenues for the years ended December 31, 2024, 2023 and 2022.
Other Income (Expense)	Other Income (Expense)
Income Taxes	Income Taxes Deferred tax assets and liabilities are recorded for the future tax consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax bases. Deferred tax assets and liabilities are measured using enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. The effect on deferred tax assets and liabilities of a change in tax law or tax rates is recognized in income in the period that includes the enactment date. Valuation allowances are provided when it is considered more likely than not that deferred tax assets will not be realized. In determining if a deductible temporary difference or net operating loss can be realized, the Company considers future reversals of existing taxable temporary differences, future taxable income, taxable income in prior carryback periods and tax planning strategies.
Contingencies	Contingencies The Company accrues for loss contingencies associated with outstanding litigation, claims and assessments for which it has determined it is probable that a loss contingency exists and the amount of loss can be reasonably estimated. The Company expenses professional fees associated with litigation claims and assessments as incurred.
Stock Based Compensation	Stock Based Compensation Stock based compensation expense is recognized at grant date fair value over the period during which an employee is required to provide service in exchange for the award. Excess tax benefits related to stock compensation are presented as a cash inflow from operating activities. The Company accounts for forfeitures when they occur.
Recently Adopted Accounting Guidance and Recent Accounting Guidance Not Yet Adopted	Recently Adopted Accounting Guidance In November 2023, the Financial Accounting Standards Board (FASB) issued Accounting Standards Update (ASU) 2023-07 - Segment Reporting: Improvements to Reportable Segment Disclosures which is intended to improve reportable segment disclosure requirements, primarily through enhanced disclosures about significant expenses. The amendments will require public entities to disclose significant segment expenses that are regularly provided to the chief operating decision-maker and included within segment profit and loss. The new standard is effective for annual periods beginning after December 15, 2023, and for interim periods within fiscal years beginning after December 15, 2024. The Company adopted the new guidance in the fourth quarter of 2024. In December 2023, the FASB issued ASU 2023-09 - Income taxes: Improvements to Income Tax Disclosures which includes amendments that further enhance income tax disclosures, primarily through standardization and disaggregation of rate reconciliation categories and income taxes paid by jurisdiction. The new standard is effective for annual periods beginning after December 15, 2024. The Company early adopted the new guidance in the fourth quarter of 2024, as permissible by the ASU. Recent Accounting Guidance Not Yet Adopted In November 2024, the FASB issued ASU 2024-03 - Income Statement - Reporting Comprehensive Income: Disaggregation of Income Statement Expenses which expands disclosures about specific expense categories presented on the face of the Statement of Operations. The new standard is effective for annual periods beginning after December 15, 2026, and interim periods beginning after December 15, 2027. The Company is currently evaluating the effect of the new disclosure requirements.

Summary of Significant Accoun_3

Summary of Significant Accounting Policies (Tables)	12 Months Ended
	Dec. 31, 2024
Accounting Policies [Abstract]
Schedule of Property Software and Equipment Depreciation Periods	Property, software and equipment are depreciated over the following periods: Fixed Asset Depreciation Period Buildings and improvements 10 - 40 years Computer hardware and software 3 - 5 years Furniture and equipment 5 - 10 years Land improvements 10 - 25 years Leasehold improvements 1 - 20 years
Schedule of Amortization Period for Intangible Assets	Intangible assets are amortized using the straight-line method over the following periods: Intangible Asset Amortization Period Purchased contract rights and customer relationships 3 - 21 years Provider contracts 4 - 15 years Trade names 7 - 20 years Developed technologies 2 - 7 years
Schedule of Allowance for Uncollectible Accounts	Year Ended December 31, 2024 2023 2022 Balance, January 1 $ 120 $ 130 $ 139 Amounts charged to expense 68 58 70 Write-offs of uncollectible receivables (77) (68) (79) Balance, December 31 $ 111 $ 120 $ 130

Short-term and Long-term Inve_2

Short-term and Long-term Investments, Restricted Deposits (Tables)	12 Months Ended
	Dec. 31, 2024
Investments, Debt and Equity Securities [Abstract]
Schedule of Short-term and Long-term Investments and Restricted Deposits by Investment Type	Short-term and long-term investments and restricted deposits by investment type consist of the following ($ in millions): December 31, 2024 December 31, 2023 Amortized Cost Gross Gross Fair Value Amortized Cost Gross Gross Fair Value Debt securities: U.S. Treasury securities and obligations of U.S. government corporations and agencies $ 593 $ 2 $ (4) $ 591 $ 403 $ — $ (8) $ 395 Corporate securities 10,820 47 (360) 10,507 9,984 78 (461) 9,601 Restricted certificates of deposit 4 — — 4 4 — — 4 Restricted cash equivalents 93 — — 93 259 — — 259 Short-term time deposits 425 — — 425 746 — — 746 Municipal securities 4,174 7 (151) 4,030 4,135 21 (171) 3,985 Asset-backed securities 1,820 13 (21) 1,812 1,665 8 (35) 1,638 Residential mortgage-backed securities 1,807 1 (129) 1,679 1,503 7 (103) 1,407 Commercial mortgage-backed securities 1,298 3 (62) 1,239 1,149 5 (82) 1,072 Equity securities 14 — — 14 17 — — 17 Private equity investments 851 — — 851 833 — — 833 Life insurance contracts 196 — — 196 174 — — 174 Total $ 22,095 $ 73 $ (727) $ 21,441 $ 20,872 $ 119 $ (860) $ 20,131
Schedule of Fair Value of Available-for-sale Debt Securities with Gross Unrealized Losses by Investment Type in a Continuous Unrealized Loss Position	The fair value of available-for-sale debt securities with gross unrealized losses by investment type and length of time that individual securities have been in a continuous unrealized loss position were as follows ($ in millions): December 31, 2024 December 31, 2023 Less Than 12 Months 12 Months or More Less Than 12 Months 12 Months or More Unrealized Losses Fair Value Unrealized Losses Fair Value Unrealized Losses Fair Value Unrealized Losses Fair Value U.S. Treasury securities and obligations of U.S. government corporations and agencies $ (1) $ 60 $ (3) $ 144 $ — $ 79 $ (8) $ 232 Corporate securities (41) 2,621 (319) 4,782 (6) 658 (455) 6,260 Municipal securities (16) 1,217 (135) 2,073 (4) 553 (167) 2,237 Asset-backed securities (4) 301 (17) 331 (2) 197 (33) 855 Residential mortgage-backed securities (18) 786 (111) 738 (2) 153 (101) 814 Commercial mortgage-backed securities (4) 210 (58) 666 (2) 114 (80) 754 Short-term time deposits — — — — — 31 — — Total $ (84) $ 5,195 $ (643) $ 8,734 $ (16) $ 1,785 $ (844) $ 11,152
Schedule of Contractual Maturities of Short-term and Long-term Investments and Restricted Deposits	The contractual maturities of short-term and long-term debt securities and restricted deposits are as follows ($ in millions): December 31, 2024 December 31, 2023 Investments Restricted Deposits Investments Restricted Deposits Amortized Cost Fair Value Amortized Cost Fair Value Amortized Cost Fair Value Amortized Cost Fair Value One year or less $ 2,383 $ 2,365 $ 477 $ 475 $ 2,308 $ 2,284 $ 566 $ 564 One year through five years 7,799 7,563 610 593 7,738 7,431 527 504 Five years through ten years 4,343 4,172 301 291 3,905 3,735 298 283 Greater than ten years 165 160 31 31 155 154 34 35 Asset-backed securities 4,925 4,730 — — 4,317 4,117 — — Total $ 19,615 $ 18,990 $ 1,419 $ 1,390 $ 18,423 $ 17,721 $ 1,425 $ 1,386

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	12 Months Ended
	Dec. 31, 2024
Fair Value Disclosures [Abstract]
Fair Value Level Input and Input Definitions	Level inputs are as follows: Level Input: Input Definition: Level I Inputs are unadjusted, quoted prices for identical assets or liabilities in active markets at the measurement date. Level II Inputs other than quoted prices included in Level I that are observable for the asset or liability through corroboration with market data at the measurement date. Level III Unobservable inputs that reflect management's best estimate of what market participants would use in pricing the asset or liability at the measurement date.
Schedule of Fair Value Measurements by Level for Assets Measured at Fair Value on a Recurring Basis	The following table summarizes fair value measurements by level at December 31, 2024, for assets and liabilities measured at fair value on a recurring basis ($ in millions): Level I Level II Level III Total Assets Cash and cash equivalents $ 14,063 $ — $ — $ 14,063 Investments: U.S. Treasury securities and obligations of U.S. government corporations and agencies $ 58 $ — $ — $ 58 Corporate securities — 10,505 — 10,505 Municipal securities — 3,272 — 3,272 Short-term time deposits — 425 — 425 Asset-backed securities — 1,812 — 1,812 Residential mortgage-backed securities — 1,679 — 1,679 Commercial mortgage-backed securities — 1,239 — 1,239 Equity securities 13 1 — 14 Total investments $ 71 $ 18,933 $ — $ 19,004 Restricted deposits: Cash and cash equivalents $ 93 $ — $ — $ 93 U.S. Treasury securities and obligations of U.S. government corporations and agencies 533 — 533 Corporate securities — 2 — 2 Certificates of deposit — 4 — 4 Municipal securities — 758 — 758 Total restricted deposits $ 626 $ 764 $ — $ 1,390 Total assets at fair value $ 14,760 $ 19,697 $ — $ 34,457 The following table summarizes fair value measurements by level at December 31, 2023, for assets and liabilities measured at fair value on a recurring basis ($ in millions): Level I Level II Level III Total Assets Cash and cash equivalents $ 17,193 $ — $ — $ 17,193 Investments: U.S. Treasury securities and obligations of U.S. government corporations and agencies $ 62 $ — $ — $ 62 Corporate securities — 9,564 — 9,564 Municipal securities — 3,232 — 3,232 Short-term time deposits — 746 — 746 Asset-backed securities — 1,638 — 1,638 Residential mortgage-backed securities — 1,407 — 1,407 Commercial mortgage-backed securities — 1,072 — 1,072 Equity securities 15 2 — 17 Total investments $ 77 $ 17,661 $ — $ 17,738 Restricted deposits: Cash and cash equivalents $ 259 $ — $ — $ 259 U.S. Treasury securities and obligations of U.S. government corporations and agencies 333 — — 333 Corporate securities — 37 — 37 Certificates of deposit — 4 — 4 Municipal securities — 753 — 753 Total restricted deposits $ 592 $ 794 $ — $ 1,386 Total assets at fair value $ 17,862 $ 18,455 $ — $ 36,317 Liabilities Accounts payable and accrued expenses: Foreign currency swap agreement $ — $ 13 $ — $ 13 Total liabilities at fair value $ — $ 13 $ — $ 13

Property, Software and Equipm_2

Property, Software and Equipment (Tables)	12 Months Ended
	Dec. 31, 2024
Property, Plant and Equipment [Abstract]
Schedule of Property, Software and Equipment	Property, software and equipment consist of the following ($ in millions): December 31, 2024 December 31, 2023 Computer software $ 3,051 $ 2,631 Computer hardware 535 542 Buildings 523 534 Furniture and office equipment 332 304 Leasehold improvements 273 252 Land 156 156 Property, software and equipment, at cost 4,870 4,419 Less: accumulated depreciation (2,803) (2,400) Property, software and equipment, net $ 2,067 $ 2,019

Goodwill and Intangible Assets

Goodwill and Intangible Assets (Tables)	12 Months Ended
	Dec. 31, 2024
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of Changes in Goodwill by Operating Segment	The following table summarizes the changes in goodwill by operating segment ($ in millions): Medicaid Medicare Commercial Other Consolidated Total Balance, December 31, 2022 $ 10,198 $ 1,592 $ 5,424 $ 1,598 $ 18,812 Divestitures — — — (912) (912) Impairments — — — (392) (392) Translation impact — — — 50 50 Balance, December 31, 2023 $ 10,198 $ 1,592 $ 5,424 $ 344 $ 17,558 Current year activity — — — — — Balance, December 31, 2024 $ 10,198 $ 1,592 $ 5,424 $ 344 $ 17,558
Schedule of Intangible Assets	Intangible assets at December 31, consist of the following ($ in millions): Weighted Average Useful Life in Years 2024 2023 2024 2023 Purchased contract rights and customer relationships $ 7,845 $ 7,845 13.5 13.5 Trade names 943 943 15.6 15.6 Provider contracts 612 612 14.0 14.0 Developed technologies 298 298 4.4 4.4 Intangible assets 9,698 9,698 13.4 13.4 Less: accumulated amortization Purchased contract rights and customer relationships (3,348) (2,768) Trade names (383) (320) Provider contracts (271) (227) Developed technologies (287) (282) Total accumulated amortization (4,289) (3,597) Intangible assets, net $ 5,409 $ 6,101
Schedule of Amortization Expense Related to Intangible Assets	Estimated total amortization expense related to the December 31, 2024 intangible assets for each of the five succeeding fiscal years is as follows ($ in millions): Estimated Total Amortization Expense 2025 $ 690 2026 673 2027 663 2028 662 2029 558

Medical Claims Liability (Table

Medical Claims Liability (Tables)	12 Months Ended
	Dec. 31, 2024
Insurance [Abstract]
Schedule of Change in Medical Claims Liability by Operating Segment	The following table summarizes the change in medical claims liability for the year ended December 31, 2024 ($ in millions): Medicaid Medicare Commercial Other Consolidated Total Balance, January 1, 2024 $ 10,814 $ 3,612 $ 3,460 $ 114 $ 18,000 Less: Reinsurance recoverables 5 — 44 — 49 Balance, January 1, 2024, net 10,809 3,612 3,416 114 17,951 Incurred related to: Current year 78,886 21,170 26,548 1,708 128,312 Prior years (1,370) (575) (509) 7 (2,447) Total incurred 77,516 20,595 26,039 1,715 125,865 Paid related to: Current year 69,351 18,036 22,547 1,522 111,456 Prior years 8,693 2,655 2,492 119 13,959 Total paid 78,044 20,691 25,039 1,641 125,415 Plus: Premium deficiency reserve — (158) — — (158) Balance, December 31, 2024, net 10,281 3,358 4,416 188 18,243 Plus: Reinsurance recoverables 18 — 47 — 65 Balance, December 31, 2024 $ 10,299 $ 3,358 $ 4,463 $ 188 $ 18,308 The following table summarizes the change in medical claims liability for the year ended December 31, 2023 ($ in millions): Medicaid Medicare Commercial Other Consolidated Total Balance, January 1, 2023 $ 11,253 $ 3,431 $ 1,921 $ 140 $ 16,745 Less: Reinsurance recoverables 7 — 19 — 26 Balance, January 1, 2023, net 11,246 3,431 1,902 140 16,719 Incurred related to: Current year 79,747 19,487 19,966 1,480 120,680 Prior years (1,537) (343) (150) (6) (2,036) Total incurred 78,210 19,144 19,816 1,474 118,644 Paid related to: Current year 69,904 16,631 16,823 1,367 104,725 Prior years 8,743 2,582 1,479 133 12,937 Total paid 78,647 19,213 18,302 1,500 117,662 Plus: Premium deficiency reserve — 250 — — 250 Balance, December 31, 2023, net 10,809 3,612 3,416 114 17,951 Plus: Reinsurance recoverables 5 — 44 — 49 Balance, December 31, 2023 $ 10,814 $ 3,612 $ 3,460 $ 114 $ 18,000 The following table summarizes the change in medical claims liability for the year ended December 31, 2022 ($ in millions): Medicaid Medicare Commercial Other Consolidated Total Balance, January 1, 2022 $ 9,845 $ 2,286 $ 2,014 $ 98 $ 14,243 Less: Reinsurance recoverables 23 — — — 23 Balance, January 1, 2022, net 9,822 2,286 2,014 98 14,220 Acquisitions and divestitures — — — 105 105 Incurred related to: Current year 76,344 19,474 14,296 2,782 112,896 Prior years (1,046) (102) (204) (15) (1,367) Total incurred 75,298 19,372 14,092 2,767 111,529 Paid related to: Current year 66,221 16,275 12,556 2,747 97,799 Prior years 7,653 1,952 1,648 83 11,336 Total paid 73,874 18,227 14,204 2,830 109,135 Balance, December 31, 2022, net 11,246 3,431 1,902 140 16,719 Plus: Reinsurance recoverables 7 — 19 — 26 Balance, December 31, 2022 $ 11,253 $ 3,431 $ 1,921 $ 140 $ 16,745
Schedule of Short-duration Insurance Contracts, Claims Development	Consolidated incurred and paid claims development as of December 31, 2024 is as follows ($ in millions): Cumulative Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance For the Year Ended December 31, Claim Year 2022 (unaudited) 2023 (unaudited) 2024 2022 $ 112,896 $ 110,870 $ 110,394 2023 120,680 118,709 2024 128,312 Total incurred claims $ 357,415 Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance For the Year Ended December 31, Claim Year 2022 (unaudited) 2023 (unaudited) 2024 2022 $ 97,799 $ 109,680 $ 110,097 2023 104,725 117,635 2024 111,456 Total payment of incurred claims 339,188 All outstanding liabilities prior to 2022, net of reinsurance 174 Medical claims liability, net of reinsurance $ 18,401 Incurred and paid claims development for the Medicaid segment as of December 31, 2024 is as follows ($ in millions): Cumulative Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance For the Year Ended December 31, Claim Year 2022 (unaudited) 2023 (unaudited) 2024 2022 $ 76,344 $ 74,861 $ 74,722 2023 79,747 78,517 2024 78,885 Total incurred claims $ 232,124 Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance For the Year Ended December 31, Claim Year 2022 (unaudited) 2023 (unaudited) 2024 2022 $ 66,220 $ 74,125 $ 74,608 2023 69,904 77,952 2024 69,351 Total payment of incurred claims 221,911 All outstanding liabilities prior to 2022, net of reinsurance 68 Medical claims liability, net of reinsurance $ 10,281 Incurred and paid claims development for the Medicare segment as of December 31, 2024 is as follows ($ in millions): Cumulative Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance For the Year Ended December 31, Claim Year 2022 (unaudited) 2023 (unaudited) 2024 2022 $ 19,475 $ 19,124 $ 19,027 2023 19,487 19,008 2024 21,171 Total incurred claims $ 59,206 Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance For the Year Ended December 31, Claim Year 2022 (unaudited) 2023 (unaudited) 2024 2022 $ 16,276 $ 18,818 $ 18,942 2023 16,631 18,778 2024 18,036 Total payment of incurred claims 55,756 All outstanding liabilities prior to 2022, net of reinsurance 66 Medical claims liability, net of reinsurance $ 3,516 Incurred and paid claims development for the Commercial segment as of December 31, 2024 is as follows ($ in millions): Cumulative Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance For the Year Ended December 31, Claim Year 2022 (unaudited) 2023 (unaudited) 2024 2022 $ 14,296 $ 14,110 $ 13,870 2023 19,966 19,698 2024 26,548 Total incurred claims $ 60,116 Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance For the Year Ended December 31, Claim Year 2022 (unaudited) 2023 (unaudited) 2024 2022 $ 12,556 $ 13,963 $ 13,773 2023 16,823 19,420 2024 22,547 Total payment of incurred claims 55,740 All outstanding liabilities prior to 2022, net of reinsurance 40 Medical claims liability, net of reinsurance $ 4,416 Incurred and paid claims development for the Other segment as of December 31, 2024 is as follows ($ in millions): Cumulative Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance For the Year Ended December 31, Claim Year 2022 (unaudited) 2023 (unaudited) 2024 2022 $ 2,781 $ 2,775 $ 2,775 2023 1,480 1,486 2024 1,708 Total incurred claims $ 5,969 Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance For the Year Ended December 31, Claim Year 2022 (unaudited) 2023 (unaudited) 2024 2022 $ 2,747 $ 2,774 $ 2,774 2023 1,367 1,485 2024 1,522 Total payment of incurred claims 5,781 All outstanding liabilities prior to 2022, net of reinsurance — Medical claims liability, net of reinsurance $ 188 Consolidated information is summarized as follows (in millions): December 31, 2024 Incurred Claims and Allocated Claim Total IBNR Plus Expected Cumulative Paid Claims 2022 $ 110,394 $ 3 638.0 2023 118,709 383 623.6 2024 128,312 12,079 641.3 Information for the Medicaid segment is summarized as follows (in millions): December 31, 2024 Incurred Claims and Allocated Claim Total IBNR Plus Expected Cumulative Paid Claims 2022 $ 74,722 $ 3 370.9 2023 78,517 218 345.6 2024 78,885 6,968 300.1 Information for the Medicare segment is summarized as follows (in millions): December 31, 2024 Incurred Claims and Allocated Claim Total IBNR Plus Expected Cumulative Paid Claims 2022 $ 19,027 $ — 204.8 2023 19,008 102 200.6 2024 21,171 1,724 253.0 Information for the Commercial segment is summarized as follows (in millions): December 31, 2024 Incurred Claims and Allocated Claim Total IBNR Plus Expected Cumulative Paid Claims 2022 $ 13,870 $ — 57.5 2023 19,698 62 72.9 2024 26,548 3,211 83.0 Information for the Other segment is summarized as follows (in millions): December 31, 2024 Incurred Claims and Allocated Claim Total IBNR Plus Expected Cumulative Paid Claims 2022 $ 2,775 $ — 4.8 2023 1,486 1 4.5 2024 1,708 176 5.2

Affordable Care Act (Tables)

Affordable Care Act (Tables)	12 Months Ended
	Dec. 31, 2024
Affordable Care Act [Abstract]
Schedule of Receivables (Payables) Related to the Affordable Care Act Programs	The Company's net receivables (payables) for each of the programs are as follows ($ in millions): December 31, 2024 December 31, 2023 Risk adjustment receivable $ 1,434 $ 893 Risk adjustment payable (1,605) (2,553) Minimum medical loss ratio (688) (164) Cost sharing reduction receivable 305 — Cost sharing reduction payable (74) (114)

Debt (Tables)

Debt (Tables)	12 Months Ended
	Dec. 31, 2024
Debt Disclosure [Abstract]
Schedule of Debt	Debt consists of the following ($ in millions): December 31, 2024 December 31, 2023 $2,500 million 4.25% Senior Notes, due December 15, 2027 $ 2,398 $ 2,395 $2,300 million 2.45% Senior Notes, due July 15, 2028 2,302 2,303 $3,500 million 4.625% Senior Notes, due December 15, 2029 3,277 3,277 $2,000 million 3.375% Senior Notes, due February 15, 2030 2,000 2,000 $2,200 million 3.00% Senior Notes, due October 15, 2030 2,200 2,200 $2,200 million 2.50% Senior Notes, due March 1, 2031 2,200 2,200 $1,300 million 2.625% Senior Notes, due August 1, 2031 1,300 1,300 Total senior notes 15,677 15,675 Term Loan Facility 2,006 2,115 Revolving Credit Agreement 950 150 Finance leases and other — 11 Debt issuance costs (100) (122) Total debt 18,533 17,829 Less: current portion (110) (119) Long-term debt $ 18,423 $ 17,710
Schedule of Aggregate Maturities of Debt	Aggregate maturities for the Company's debt for the years ending December 31, are as follows ($ in millions): Aggregate Maturities 2025 $ 110 2026 2,848 2027 2,405 2028 2,300 2029 3,277 Thereafter 7,700 Total $ 18,640

Leases (Tables)

Leases (Tables)	12 Months Ended
	Dec. 31, 2024
Leases [Abstract]
Schedule of ROU Assets and Liabilities	The following table sets forth the ROU assets and lease liabilities ($ in millions): December 31, 2024 December 31, 2023 Assets ROU assets (recorded within other long-term assets) $ 359 $ 396 Liabilities Short-term (recorded within accounts payable and accrued expenses) $ 158 $ 168 Long-term (recorded within other long-term liabilities) 738 880 Total lease liabilities $ 896 $ 1,048
Schedule of Operating Lease Maturity	Lease payments over the next five years and thereafter are as follows ($ in millions): Lease Payments 2025 $ 185 2026 157 2027 134 2028 112 2029 98 Thereafter 334 Total lease payments 1,020 Less: imputed interest (124) Total lease liabilities $ 896

Stockholders' Equity (Tables)

Stockholders' Equity (Tables)	12 Months Ended
	Dec. 31, 2024
Equity [Abstract]
Schedule of Share Repurchase Activity	The following represents the Company's share repurchase activity ($ in millions, shares in thousands): Year Ended December 31, 2024 2023 2022 (2) Shares Cost Shares Cost Shares Cost Share buybacks 41,987 $ 2,999 22,886 $ 1,577 35,655 $ 2,994 Income tax withholding 1,494 114 828 56 1,213 102 Total share repurchases (1) 43,481 $ 3,113 23,714 $ 1,633 36,868 $ 3,096 (1) Excludes year-to-date share repurchase excise tax of approximately $28 million and $10 million accrued as of December 31, 2024 and 2023, respectively. (2) Includes 11.6 million shares delivered as part of an accelerated share repurchase (ASR) agreement with a $1,000 million notional amount. The Company purchased additional shares throughout the year through open market repurchases, including repurchase plans designed to comply with Rule 10b5-1.

Income Taxes (Tables)

Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2024
Income Tax Disclosure [Abstract]
Schedule of Consolidated Income Tax Expense	The consolidated income tax expense consists of the following ($ in millions): Year Ended December 31, 2024 2023 2022 Income (loss) from continuing operations before income tax expense (benefit) U.S. Federal $ 3,529 $ 3,686 $ 1,938 Foreign (1) 728 (88) 24 Total $ 4,257 $ 3,598 $ 1,962 Income tax expense (benefit) from continuing operations Current tax expense Federal $ 798 $ 833 $ 1,144 State and local 142 132 261 Foreign — 1 4 Total current tax expense $ 940 $ 966 $ 1,409 Deferred tax expense (benefit) Federal $ 8 $ (71) $ (514) State and local 7 33 (126) Foreign 8 (29) (9) Total deferred tax expense (benefit) $ 23 $ (67) $ (649) Total income tax expense (benefit) Federal $ 806 $ 762 $ 630 State and local 149 165 135 Foreign 8 (28) (5) Total income tax expense (benefit) $ 963 $ 899 $ 760 (1) Foreign income from continuing operations includes the Company's Cayman Islands reinsurance entity. The Company has elected for its Cayman Islands entity to be taxed as a U.S. corporation and pays U.S. tax at the 21% tax rate. The U.S. tax resulting from this entity is included in Federal income tax expense. This entity is expected to cease operating in 2025.
Schedule of Reconciliation of Tax Provision at the U.S. Federal Statutory Rate to Income Tax Expense	The reconciliation of the tax provision at the U.S. federal statutory rate to income tax expense is as follows ($ in millions): Year Ended December 31, 2024 2023 2022 Total % Total % Total % Earnings from continuing operations, before income tax expense $ 4,257 $ 3,598 $ 1,962 Tax provision at the U.S. federal statutory rate 894 21.0 % 756 21.0 % 412 21.0 % Federal Effect of cross-border tax laws Global Intangible Low-Taxed Income (GILTI) 44 1.0 % 4 0.1 % — — % Cayman Islands Statutory income tax rate differential (1) 142 3.3 % 62 1.7 % 6 0.3 % Other 2 — % (21) (0.6) % (1) (0.1) % Tax credits (14) (0.3) % (5) (0.1) % (8) (0.4) % Changes in valuation allowances (12) (0.3) % (2) (0.1) % (11) (0.6) % Nontaxable or nondeductible items Nondeductible compensation 37 0.9 % 29 0.8 % 51 2.6 % Nondeductible goodwill — — % — — % 56 2.9 % Nontaxable or nondeductible divestiture (gains) losses (97) (2.3) % (9) (0.3) % 79 4.0 % Other nontaxable or nondeductible items (1) — % (6) (0.2) % 13 0.7 % Other Deferred taxes for investments in subsidiaries — — % — — % 70 3.6 % Excess tax benefit on stock awards (3) (0.1) % (59) (1.6) % (13) (0.7) % Other 9 0.2 % 26 0.7 % 29 1.5 % Foreign tax effects United Kingdom Nondeductible goodwill (34) (0.8) % 83 2.3 % — — % Other 12 0.3 % (26) (0.7) % (2) (0.1) % Cayman Islands Statutory income tax rate differential (1) (142) (3.3) % (62) (1.7) % (6) (0.3) % Other jurisdictions 7 0.2 % (16) (0.4) % — — % Changes in unrecognized tax benefits 24 0.6 % 27 0.8 % 13 0.7 % State income taxes, net of federal income tax benefit (2) 95 2.2 % 118 3.3 % 72 3.7 % Income tax expense $ 963 22.6 % $ 899 25.0 % $ 760 38.7 % (1) The Company has elected for its Cayman Islands reinsurance entity to be taxed as a U.S. corporation and pays U.S. tax at the 21% tax rate. The taxability of this entity does not represent a reconciling item between the U.S. federal rate and the Company's effective tax rate. This entity ceased to operate in 2025. (2) During the year ended December 31, 2024, state taxes in California, Florida and Illinois comprised greater than 50% of the tax effect in this category. During the year ended December 31, 2023, state taxes in California and Florida comprised greater than 50% of the tax effect in this category. During the year ended December 31, 2022, state taxes in California and Pennsylvania comprised greater than 50% of the tax effect in this category.
Schedule of Income Taxes Paid	Income taxes paid are as follows ($ in millions): Year Ended December 31, 2024 2023 2022 U.S. Federal (1) $ 930 $ 698 $ 1,009 Pennsylvania * 53 * Other (2) 71 138 175 Total U.S. State and Local 71 191 175 Foreign 1 (2) 14 Total income taxes paid, net $ 1,002 $ 887 $ 1,198 (1) Includes amounts paid to purchase transferable tax credits of $100 million and $49 million during the years ended December 31, 2024 and 2023, respectively. (2) Includes amounts paid to purchase transferable tax credits of $15 million, $10 million and $19 million during the years ended December 31, 2024, 2023 and 2022, respectively. * The amount of income taxes paid during the years ended December 31, 2024 and 2022 does not meet the 5% disaggregation threshold.
Schedule of Tax Effects of Temporary Differences Which Give Rise to Deferred Tax Assets and Liabilities	The tax effects of temporary differences which give rise to deferred tax assets and liabilities are presented below ($ in millions): December 31, 2024 December 31, 2023 Deferred tax assets: Medical claims liability $ 178 $ 217 Nondeductible liabilities 81 111 Net operating loss and tax credit carryforwards 70 71 Compensation accruals 93 113 Premium and trade receivables 72 94 Operating lease liability 231 269 Unrealized gain/loss 153 179 Software development costs 246 193 Other 92 92 Deferred tax assets 1,216 1,339 Valuation allowance (77) (82) Net deferred tax assets $ 1,139 $ 1,257 Deferred tax liabilities: Goodwill and intangible assets $ 1,518 $ 1,603 Fixed assets 135 127 Right-of-use asset 88 98 Other 82 70 Deferred tax liabilities 1,823 1,898 Net deferred tax liabilities $ (684) $ (641)
Schedule of Unrecognized Tax Benefits Roll Forward	The Company maintains a reserve for uncertain tax positions that may be challenged by a tax authority. A rollforward of the beginning and ending amount of uncertain tax positions, exclusive of related interest and penalties, is as follows ($ in millions): Year Ended December 31, 2024 2023 Gross unrecognized tax benefits, January 1 $ 439 $ 410 Gross increases: Current year tax positions 16 19 Prior year tax positions 31 29 Gross decreases: Settlements (1) (133) (2) Prior year tax positions (6) (10) Statute of limitation lapses (7) (7) Gross unrecognized tax benefits, December 31 $ 340 $ 439 (1) Primarily reflects the resolution of an item that had no net impact on the Consolidated Statement of Operations.

Stock Incentive Plans (Tables)

Stock Incentive Plans (Tables)	12 Months Ended
	Dec. 31, 2024
Share-Based Payment Arrangement [Abstract]
Summary of Non-Vested Restricted Stock and Restricted Stock	A summary of the Company's non-vested restricted stock and restricted stock unit shares as of December 31, 2024, and changes during the year ended December 31, 2024, is presented below (shares in thousands): Shares Weighted Average Non-vested balance, December 31, 2023 7,462 $ 68.96 Granted 3,741 76.84 Vested (4,196) 69.42 Forfeited (655) 70.88 Non-vested balance, December 31, 2024 6,352 $ 73.10

Earnings Per Share (Tables)

Earnings Per Share (Tables)	12 Months Ended
	Dec. 31, 2024
Earnings Per Share [Abstract]
Calculation Of Basic And Diluted Net Earnings Per Common Share	The following table sets forth the calculation of basic and diluted net earnings per common share ($ in millions, except per share data in dollars and shares in thousands): Year Ended December 31, 2024 2023 2022 Earnings attributable to Centene Corporation $ 3,305 $ 2,702 $ 1,202 Shares used in computing per share amounts: Weighted average number of common shares outstanding 521,790 543,319 575,191 Common stock equivalents (as determined by applying the treasury stock method) 1,954 2,385 6,849 Weighted average number of common shares and potential dilutive common shares outstanding 523,744 545,704 582,040 Net earnings per common share attributable to Centene Corporation: Basic earnings per common share $ 6.33 $ 4.97 $ 2.09 Diluted earnings per common share $ 6.31 $ 4.95 $ 2.07

Segment Information (Tables)

Segment Information (Tables)	12 Months Ended
	Dec. 31, 2024
Segment Reporting [Abstract]
Schedule of Segment Information	Segment information for the year ended December 31, 2024, is as follows ($ in millions): Medicaid Medicare Commercial Other/Eliminations Consolidated Total Premium $ 83,758 $ 23,032 $ 33,699 $ 1,814 $ 142,303 Service 93 — 3 3,106 3,202 Premium and service revenues 83,851 23,032 33,702 4,920 145,505 Premium tax 17,566 — — — 17,566 Total external revenues 101,417 23,032 33,702 4,920 163,071 Internal revenues — — — 16,879 16,879 Eliminations — — — (16,879) (16,879) Total revenues $ 101,417 $ 23,032 $ 33,702 $ 4,920 $ 163,071 Medical costs $ 77,516 $ 20,437 $ 26,039 $ 1,715 $ 125,707 Cost of services 89 — — 2,640 2,729 Other operating expenses (1) 31,460 Other income (expense) (2) 1,082 Earnings before income tax expense $ 4,257 Segment gross margin (3) $ 6,246 $ 2,595 $ 7,663 $ 565 $ 17,069 (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 year ended December 31, 2023, is as follows ($ in millions): Medicaid Medicare Commercial Other/Eliminations Consolidated Total Premium $ 86,853 $ 22,261 $ 24,843 $ 1,679 $ 135,636 Service 2 — 2 4,455 4,459 Premium and service revenues 86,855 22,261 24,845 6,134 140,095 Premium tax 13,904 — — — 13,904 Total external revenues 100,759 22,261 24,845 6,134 153,999 Internal revenues — — — 16,735 16,735 Eliminations — — — (16,735) (16,735) Total revenues $ 100,759 $ 22,261 $ 24,845 $ 6,134 $ 153,999 Medical costs $ 78,210 $ 19,394 $ 19,816 $ 1,474 $ 118,894 Cost of services 4 — — 3,560 3,564 Other operating expenses (1) 28,611 Other income (expense) (2) 668 Earnings before income tax expense $ 3,598 Segment gross margin (3) $ 8,641 $ 2,867 $ 5,029 $ 1,100 $ 17,637 (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 year ended December 31, 2022, is as follows ($ in millions): Medicaid Medicare Commercial Other/Eliminations Consolidated Total Premium $ 84,084 $ 22,484 $ 17,377 $ 3,186 $ 127,131 Service (1) — 3 8,346 8,348 Premium and service revenues 84,083 22,484 17,380 11,532 135,479 Premium tax 9,068 — — — 9,068 Total external revenues 93,151 22,484 17,380 11,532 144,547 Internal revenues — — — 25,191 25,191 Eliminations — — — (25,191) (25,191) Total revenues $ 93,151 $ 22,484 $ 17,380 $ 11,532 $ 144,547 Medical costs $ 75,298 $ 19,372 $ 14,092 $ 2,767 $ 111,529 Cost of services — — — 7,032 7,032 Other operating expenses (1) 24,668 Other income (expense) (2) 644 Earnings before income tax expense $ 1,962 Segment gross margin (3) $ 8,785 $ 3,112 $ 3,288 $ 1,733 $ 16,918 (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.

Condensed Financial Informati_2

Condensed Financial Information of Registrant (Tables)	12 Months Ended
	Dec. 31, 2024
Condensed Financial Information Disclosure [Abstract]
Schedule of Condensed Balance Sheets	Centene Corporation (Parent Company Only) Condensed Balance Sheets (In millions, except shares in thousands and per share data in dollars) December 31, 2024 December 31, 2023 ASSETS Current assets: Cash and cash equivalents $ 7 $ 7 Other current assets 9 7 Total current assets 16 14 Long-term investments 206 264 Investment in subsidiaries 45,148 43,853 Other long-term assets 85 186 Total assets $ 45,455 $ 44,317 LIABILITIES, REDEEMABLE NONCONTROLLING INTERESTS AND STOCKHOLDERS' EQUITY Current liabilities: Current liabilities $ 243 $ 417 Current portion of long-term debt 110 110 Total current liabilities 353 527 Long-term debt 18,423 17,708 Other long-term liabilities 169 126 Total liabilities 18,945 18,361 Commitments and contingencies Redeemable noncontrolling interest 10 19 Stockholders' equity: Preferred stock, $0.001 par value; authorized 10,000 shares; no shares issued or outstanding at December 31, 2024 and December 31, 2023 — — Common stock, $0.001 par value; authorized 800,000 shares; 620,195 issued and 495,907 outstanding at December 31, 2024, and 615,291 issued and 534,484 outstanding at December 31, 2023 1 1 Additional paid-in capital 20,562 20,304 Accumulated other comprehensive (loss) (504) (652) Retained earnings 15,348 12,043 Treasury stock, at cost (124,288 and 80,807 shares, respectively) (8,997) (5,856) Total Centene stockholders' equity 26,410 25,840 Nonredeemable noncontrolling interest 90 97 Total stockholders' equity 26,500 25,937 Total liabilities, redeemable noncontrolling interests and stockholders' equity $ 45,455 $ 44,317
Schedule of Condensed Statements of Operations	Centene Corporation (Parent Company Only) Condensed Statements of Operations (In millions, except per share data in dollars) Year Ended December 31, 2024 2023 2022 Expenses: Selling, general and administrative expenses $ 13 $ 14 $ 21 Legal settlement — — 33 Other income (expense): Investment and other income (34) (47) 55 Gain (loss) on divestiture (34) 108 13 Debt extinguishment — — 14 Interest expense (700) (710) (643) (Loss) before income taxes (781) (663) (615) Income tax (benefit) (76) (118) (208) Net (loss) before equity in subsidiaries (705) (545) (407) Equity in earnings from subsidiaries 3,999 3,244 1,609 Net earnings 3,294 2,699 1,202 Loss attributable to noncontrolling interests 11 3 — Net earnings attributable to Centene Corporation $ 3,305 $ 2,702 $ 1,202 Net earnings per common share attributable to Centene Corporation: Basic earnings per common share $ 6.33 $ 4.97 $ 2.09 Diluted earnings per common share $ 6.31 $ 4.95 $ 2.07
Schedule of Condensed Statements of Cash Flows	Centene Corporation (Parent Company Only) Condensed Statements of Cash Flows (In millions) Year Ended December 31, 2024 2023 2022 Cash flows from operating activities: Dividends from subsidiaries, return on investment $ 1,797 $ 2,823 $ 1,706 Payments for legal settlement (263) (326) (282) Other operating activities, net (422) (334) (450) Net cash provided by operating activities 1,112 2,163 974 Cash flows from investing activities: Capital contributions to subsidiaries (730) (443) (880) Purchases of investments (2) (202) (2) Dividends from subsidiaries, return of investment 321 85 10 Investments in acquisitions — — (2,431) Proceeds from divestitures — 325 — Intercompany activities 1,693 (357) 5,785 Other investing activities, net — — 3 Net cash (used in) provided by investing activities 1,282 (592) 2,485 Cash flows from financing activities: Proceeds from common stock issuances 46 44 70 Proceeds from long-term debt 1,300 2,305 75 Payments and repurchases of long-term debt (610) (2,290) (491) Common stock repurchases (3,124) (1,633) (3,096) Payments for debt extinguishment — — (14) Other financing activities, net (6) (2) — Net cash used in financing activities (2,394) (1,576) (3,456) Net increase (decrease) in cash and cash equivalents — (5) 3 Cash and cash equivalents, beginning of period 7 12 9 Cash and cash equivalents, end of period $ 7 $ 7 $ 12

Organization and Operations (De

Organization and Operations (Details)	12 Months Ended
	Dec. 31, 2024 segment
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Number of operating segments	4

Summary of Significant Accoun_4

Summary of Significant Accounting Policies - Schedule of Property, Software and Equipment Depreciation Periods (Details)	Dec. 31, 2024
Buildings and improvements | Minimum
Property, Plant and Equipment [Line Items]
Depreciation Period	10 years
Buildings and improvements | Maximum
Property, Plant and Equipment [Line Items]
Depreciation Period	40 years
Computer hardware and software | Minimum
Property, Plant and Equipment [Line Items]
Depreciation Period	3 years
Computer hardware and software | Maximum
Property, Plant and Equipment [Line Items]
Depreciation Period	5 years
Furniture and equipment | Minimum
Property, Plant and Equipment [Line Items]
Depreciation Period	5 years
Furniture and equipment | Maximum
Property, Plant and Equipment [Line Items]
Depreciation Period	10 years
Land improvements | Minimum
Property, Plant and Equipment [Line Items]
Depreciation Period	10 years
Land improvements | Maximum
Property, Plant and Equipment [Line Items]
Depreciation Period	25 years
Leasehold improvements | Minimum
Property, Plant and Equipment [Line Items]
Depreciation Period	1 year
Leasehold improvements | Maximum
Property, Plant and Equipment [Line Items]
Depreciation Period	20 years

Summary of Significant Accoun_5

Summary of Significant Accounting Policies - Schedule of Amortization Period for Intangible Assets (Details) - segment	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023
Finite-Lived Intangible Assets [Line Items]
Amortization Period	13 years 4 months 24 days	13 years 4 months 24 days
Number of operating segments	4
Purchased contract rights and customer relationships
Finite-Lived Intangible Assets [Line Items]
Amortization Period	13 years 6 months	13 years 6 months
Purchased contract rights and customer relationships | Minimum
Finite-Lived Intangible Assets [Line Items]
Amortization Period	3 years
Purchased contract rights and customer relationships | Maximum
Finite-Lived Intangible Assets [Line Items]
Amortization Period	21 years
Provider contracts
Finite-Lived Intangible Assets [Line Items]
Amortization Period	14 years	14 years
Provider contracts | Minimum
Finite-Lived Intangible Assets [Line Items]
Amortization Period	4 years
Provider contracts | Maximum
Finite-Lived Intangible Assets [Line Items]
Amortization Period	15 years
Trade names
Finite-Lived Intangible Assets [Line Items]
Amortization Period	15 years 7 months 6 days	15 years 7 months 6 days
Trade names | Minimum
Finite-Lived Intangible Assets [Line Items]
Amortization Period	7 years
Trade names | Maximum
Finite-Lived Intangible Assets [Line Items]
Amortization Period	20 years
Developed technologies
Finite-Lived Intangible Assets [Line Items]
Amortization Period	4 years 4 months 24 days	4 years 4 months 24 days
Developed technologies | Minimum
Finite-Lived Intangible Assets [Line Items]
Amortization Period	2 years
Developed technologies | Maximum
Finite-Lived Intangible Assets [Line Items]
Amortization Period	7 years

Summary of Significant Accoun_6

Summary of Significant Accounting Policies - Medical Claims Liability (Details) - USD ($) $ in Millions	Dec. 31, 2024	Dec. 31, 2023
Segment Reporting Information [Line Items]
Premium deficiency reserve liability	$ (158)	$ 250
Medicare
Segment Reporting Information [Line Items]
Premium deficiency reserve liability	(158)	250
Medicare Advantage 2024 | Medicare
Segment Reporting Information [Line Items]
Premium deficiency reserve liability		$ 250
Medicare Advantage 2025 | Medicare
Segment Reporting Information [Line Items]
Premium deficiency reserve liability	$ 92

Summary of Significant Accoun_7

Summary of Significant Accounting Policies - Schedule of Allowance for Uncollectible Accounts (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Accounts Receivable, Allowance for Credit Loss [Roll Forward]
Balance, January 1	$ 120	$ 130	$ 139
Amounts charged to expense	68	58	70
Write-offs of uncollectible receivables	(77)	(68)	(79)
Balance, December 31	$ 111	$ 120	$ 130

Summary of Significant Accoun_8

Summary of Significant Accounting Policies - Significant Customers (Details)	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Accounting Policies [Abstract]
Percentage of revenues under contracts or subcontracts	0%	0%	0%

Acquisitions and Divestitures -

Acquisitions and Divestitures - Divestitures (Details) £ in Millions, $ in Millions			1 Months Ended	12 Months Ended
	Jan. 12, 2024 USD ($)	Dec. 02, 2022 USD ($)	Apr. 30, 2023 USD ($)	Dec. 31, 2024 USD ($)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 USD ($)	Aug. 31, 2023 USD ($)	Aug. 31, 2023 GBP (£)	Jan. 20, 2023 USD ($)
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Impairment charge				$ 13	$ 529	$ 2,318
(Gain) loss on divestitures, net				(120)	(152)	(772)
Goodwill impairment					392
Net tax benefit				(963)	(899)	(760)
Foreign currency swap agreement
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Derivative notional amount							$ 931	£ 740
Fair value of swap agreement					13
Spanish and Central European Businesses | Disposal Group, Held-for-sale or Disposed of by Sale, Not Discontinued Operations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Impairment charge						163
Impairment charge, net of tax						140
(Gain) loss on divestitures, net					13
Gain (loss) on divestitures, net of tax					(10)
Magellan Rx | Disposal Group, Disposed of by Sale, Not Discontinued Operations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
(Gain) loss on divestitures, net		$ (269)			(22)
Gain (loss) on divestitures, net of tax		(99)			(10)
Proceeds from divestitures		$ 1,337
Magellan Specialty Health | Disposal Group, Held-for-sale or Disposed of by Sale, Not Discontinued Operations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Gain (loss) on divestitures, net of tax					(68)
Magellan Specialty Health | Disposal Group, Disposed of by Sale, Not Discontinued Operations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
(Gain) loss on divestitures, net				(83)	(79)
Proceeds from divestitures			$ 245
Consideration on divestiture									$ 646
Centurion | Disposal Group, Held-for-sale or Disposed of by Sale, Not Discontinued Operations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Impairment charge						259
Impairment charge, net of tax						181
(Gain) loss on divestitures, net					(15)
Gain (loss) on divestitures, net of tax					(10)
HealthSmart | Disposal Group, Held-for-sale or Disposed of by Sale, Not Discontinued Operations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Impairment charge						36
Impairment charge, net of tax						$ 27
Apixio | Disposal Group, Disposed of by Sale, Not Discontinued Operations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
(Gain) loss on divestitures, net					(93)
Gain (loss) on divestitures, net of tax					(67)
Circle Health | Disposal Group, Disposed of by Sale, Not Discontinued Operations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
(Gain) loss on divestitures, net				(20)
Net tax benefit				40
Circle Health | Disposal Group, Held-for-Sale, Not Discontinued Operations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Proceeds from divestitures	$ 931
Assets held for sale					3,897
Liabilities held for sale					3,094
Goodwill impairment					292
Goodwill impairment, net of tax					258
Operose Health | Disposal Group, Disposed of by Sale, Not Discontinued Operations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Impairment charge					140
Impairment charge, net of tax					$ 128
Collaborative Health Systems | Disposal Group, Disposed of by Sale, Not Discontinued Operations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
(Gain) loss on divestitures, net				(17)
Gain (loss) on divestitures, net of tax				$ (13)

Short-term and Long-term Inve_3

Short-term and Long-term Investments, Restricted Deposits - Schedule of By Investment Type (Details) - USD ($) $ in Millions	Dec. 31, 2024	Dec. 31, 2023
Debt Securities
Gross Unrealized Gains	$ 73	$ 119
Gross Unrealized Losses	(727)	(860)
Equity securities	14	17
Private equity investments	851	833
Life insurance contracts	196	174
Total, Amortized Cost	22,095	20,872
Total, Fair Value	21,441	20,131
U.S. Treasury securities and obligations of U.S. government corporations and agencies
Debt Securities
Amortized Cost	593	403
Gross Unrealized Gains	2	0
Gross Unrealized Losses	(4)	(8)
Fair Value	591	395
Corporate securities
Debt Securities
Amortized Cost	10,820	9,984
Gross Unrealized Gains	47	78
Gross Unrealized Losses	(360)	(461)
Fair Value	10,507	9,601
Restricted certificates of deposit
Debt Securities
Amortized Cost	4	4
Gross Unrealized Gains	0	0
Gross Unrealized Losses	0	0
Fair Value	4	4
Restricted cash equivalents
Debt Securities
Amortized Cost	93	259
Gross Unrealized Gains	0	0
Gross Unrealized Losses	0	0
Fair Value	93	259
Short-term time deposits
Debt Securities
Amortized Cost	425	746
Gross Unrealized Gains	0	0
Gross Unrealized Losses	0	0
Fair Value	425	746
Municipal securities
Debt Securities
Amortized Cost	4,174	4,135
Gross Unrealized Gains	7	21
Gross Unrealized Losses	(151)	(171)
Fair Value	4,030	3,985
Asset-backed securities
Debt Securities
Amortized Cost	1,820	1,665
Gross Unrealized Gains	13	8
Gross Unrealized Losses	(21)	(35)
Fair Value	1,812	1,638
Residential mortgage-backed securities
Debt Securities
Amortized Cost	1,807	1,503
Gross Unrealized Gains	1	7
Gross Unrealized Losses	(129)	(103)
Fair Value	1,679	1,407
Commercial mortgage-backed securities
Debt Securities
Amortized Cost	1,298	1,149
Gross Unrealized Gains	3	5
Gross Unrealized Losses	(62)	(82)
Fair Value	$ 1,239	$ 1,072

Short-term and Long-term Inve_4

Short-term and Long-term Investments, Restricted Deposits - Narrative (Details) $ in Millions	12 Months Ended
	Dec. 31, 2024 USD ($) position	Dec. 31, 2023 USD ($)
Debt Securities, Available-for-sale [Line Items]
Impairment of private equity investment | $	$ 50
Accrued interest income | $	$ 178	$ 153
Debt Securities, Available-for-Sale, Accrued Interest, after Allowance for Credit Loss, Statement of Financial Position [Extensible Enumeration]	Other Assets, Current	Other Assets, Current
Positions from which gross unrealized losses were generated | position	5,276
Total investment positions | position	6,750
Commercial mortgage-backed securities
Debt Securities, Available-for-sale [Line Items]
Investments recorded at fair value that carry weighted average rating of AA plus, period	3 years
Rated Securities | External Credit Rating, Investment Grade | Investment Securities
Debt Securities, Available-for-sale [Line Items]
Percentage of investments in rated securities carry an investment grade rating by nationally recognized statistical rating organizations	99%

Short-term and Long-term Inve_5

Short-term and Long-term Investments, Restricted Deposits - Schedule of Fair Value of Available-for-Sale Investments in a Continuous Unrealized Loss Position (Details) - USD ($) $ in Millions	Dec. 31, 2024	Dec. 31, 2023
Unrealized Losses
Less Than 12 Months	$ (84)	$ (16)
12 Months or More	(643)	(844)
Fair Value
Less Than 12 Months	5,195	1,785
12 Months or More	8,734	11,152
U.S. Treasury securities and obligations of U.S. government corporations and agencies
Unrealized Losses
Less Than 12 Months	(1)	0
12 Months or More	(3)	(8)
Fair Value
Less Than 12 Months	60	79
12 Months or More	144	232
Corporate securities
Unrealized Losses
Less Than 12 Months	(41)	(6)
12 Months or More	(319)	(455)
Fair Value
Less Than 12 Months	2,621	658
12 Months or More	4,782	6,260
Municipal securities
Unrealized Losses
Less Than 12 Months	(16)	(4)
12 Months or More	(135)	(167)
Fair Value
Less Than 12 Months	1,217	553
12 Months or More	2,073	2,237
Asset-backed securities
Unrealized Losses
Less Than 12 Months	(4)	(2)
12 Months or More	(17)	(33)
Fair Value
Less Than 12 Months	301	197
12 Months or More	331	855
Residential mortgage-backed securities
Unrealized Losses
Less Than 12 Months	(18)	(2)
12 Months or More	(111)	(101)
Fair Value
Less Than 12 Months	786	153
12 Months or More	738	814
Commercial mortgage-backed securities
Unrealized Losses
Less Than 12 Months	(4)	(2)
12 Months or More	(58)	(80)
Fair Value
Less Than 12 Months	210	114
12 Months or More	666	754
Short-term time deposits
Unrealized Losses
Less Than 12 Months	0	0
12 Months or More	0	0
Fair Value
Less Than 12 Months	0	31
12 Months or More	$ 0	$ 0

Short-term and Long-term Inve_6

Short-term and Long-term Investments, Restricted Deposits - Schedule of Contractual Maturities of Short-term and Long-term Investments and Restricted Deposits (Details) - USD ($) $ in Millions	Dec. 31, 2024	Dec. 31, 2023
Investments
Amortized Cost
One year or less	$ 2,383	$ 2,308
One year through five years	7,799	7,738
Five years through ten years	4,343	3,905
Greater than ten years	165	155
Asset-backed securities	4,925	4,317
Amortized Cost	19,615	18,423
Fair Value
One year or less	2,365	2,284
One year through five years	7,563	7,431
Five years through ten years	4,172	3,735
Greater than ten years	160	154
Asset-backed securities	4,730	4,117
Fair Value	18,990	17,721
Restricted Deposits
Amortized Cost
One year or less	477	566
One year through five years	610	527
Five years through ten years	301	298
Greater than ten years	31	34
Asset-backed securities	0	0
Amortized Cost	1,419	1,425
Fair Value
One year or less	475	564
One year through five years	593	504
Five years through ten years	291	283
Greater than ten years	31	35
Asset-backed securities	0	0
Fair Value	$ 1,390	$ 1,386

Fair Value Measurements - Sched

Fair Value Measurements - Schedule of Fair Value Measurements by Level for Assets and Liabilities Measured at Fair Value on a Recurring Basis (Details) - USD ($) $ in Millions	Dec. 31, 2024	Dec. 31, 2023
Assets
Cash and cash equivalents	$ 14,063	$ 17,193
Investments:
Equity securities	14	17
Total assets at fair value	34,457	36,317
Total liabilities at fair value		13
Accounts payable and accrued expenses: | Foreign currency swap agreement
Investments:
Derivative liability fair value		13
U.S. Treasury securities and obligations of U.S. government corporations and agencies
Investments:
Fair value	591	395
Corporate securities
Investments:
Fair value	10,507	9,601
Municipal securities
Investments:
Fair value	4,030	3,985
Short-term time deposits
Investments:
Fair value	425	746
Asset-backed securities
Investments:
Fair value	1,812	1,638
Residential mortgage-backed securities
Investments:
Fair value	1,679	1,407
Commercial mortgage-backed securities
Investments:
Fair value	1,239	1,072
Level I
Assets
Cash and cash equivalents	14,063	17,193
Investments:
Total assets at fair value	14,760	17,862
Total liabilities at fair value		0
Level I | Accounts payable and accrued expenses: | Foreign currency swap agreement
Investments:
Derivative liability fair value		0
Level II
Assets
Cash and cash equivalents	0	0
Investments:
Total assets at fair value	19,697	18,455
Total liabilities at fair value		13
Level II | Accounts payable and accrued expenses: | Foreign currency swap agreement
Investments:
Derivative liability fair value		13
Level III
Assets
Cash and cash equivalents	0	0
Investments:
Total assets at fair value	0	0
Total liabilities at fair value		0
Level III | Accounts payable and accrued expenses: | Foreign currency swap agreement
Investments:
Derivative liability fair value		0
Investments:
Investments:
Fair value	18,990	17,721
Total investments	19,004	17,738
Investments: | U.S. Treasury securities and obligations of U.S. government corporations and agencies
Investments:
Fair value	58	62
Investments: | Corporate securities
Investments:
Fair value	10,505	9,564
Investments: | Municipal securities
Investments:
Fair value	3,272	3,232
Investments: | Short-term time deposits
Investments:
Fair value	425	746
Investments: | Asset-backed securities
Investments:
Fair value	1,812	1,638
Investments: | Residential mortgage-backed securities
Investments:
Fair value	1,679	1,407
Investments: | Commercial mortgage-backed securities
Investments:
Fair value	1,239	1,072
Investments: | Equity Securities
Investments:
Equity securities	14	17
Investments: | Level I
Investments:
Total investments	71	77
Investments: | Level I | U.S. Treasury securities and obligations of U.S. government corporations and agencies
Investments:
Fair value	58	62
Investments: | Level I | Corporate securities
Investments:
Fair value	0	0
Investments: | Level I | Municipal securities
Investments:
Fair value	0	0
Investments: | Level I | Short-term time deposits
Investments:
Fair value	0	0
Investments: | Level I | Asset-backed securities
Investments:
Fair value	0	0
Investments: | Level I | Residential mortgage-backed securities
Investments:
Fair value	0	0
Investments: | Level I | Commercial mortgage-backed securities
Investments:
Fair value	0	0
Investments: | Level I | Equity Securities
Investments:
Equity securities	13	15
Investments: | Level II
Investments:
Total investments	18,933	17,661
Investments: | Level II | U.S. Treasury securities and obligations of U.S. government corporations and agencies
Investments:
Fair value	0	0
Investments: | Level II | Corporate securities
Investments:
Fair value	10,505	9,564
Investments: | Level II | Municipal securities
Investments:
Fair value	3,272	3,232
Investments: | Level II | Short-term time deposits
Investments:
Fair value	425	746
Investments: | Level II | Asset-backed securities
Investments:
Fair value	1,812	1,638
Investments: | Level II | Residential mortgage-backed securities
Investments:
Fair value	1,679	1,407
Investments: | Level II | Commercial mortgage-backed securities
Investments:
Fair value	1,239	1,072
Investments: | Level II | Equity Securities
Investments:
Equity securities	1	2
Investments: | Level III
Investments:
Total investments	0	0
Investments: | Level III | U.S. Treasury securities and obligations of U.S. government corporations and agencies
Investments:
Fair value	0	0
Investments: | Level III | Corporate securities
Investments:
Fair value	0	0
Investments: | Level III | Municipal securities
Investments:
Fair value	0	0
Investments: | Level III | Short-term time deposits
Investments:
Fair value	0	0
Investments: | Level III | Asset-backed securities
Investments:
Fair value	0	0
Investments: | Level III | Residential mortgage-backed securities
Investments:
Fair value	0	0
Investments: | Level III | Commercial mortgage-backed securities
Investments:
Fair value	0	0
Investments: | Level III | Equity Securities
Investments:
Equity securities	0	0
Restricted deposits:
Investments:
Fair value	1,390	1,386
Restricted deposits: | U.S. Treasury securities and obligations of U.S. government corporations and agencies
Investments:
Fair value	533	333
Restricted deposits: | Corporate securities
Investments:
Fair value	2	37
Restricted deposits: | Municipal securities
Investments:
Fair value	758	753
Restricted deposits: | Cash and cash equivalents
Investments:
Fair value	93	259
Restricted deposits: | Certificates of deposit
Investments:
Fair value	4	4
Restricted deposits: | Level I
Investments:
Fair value	626	592
Restricted deposits: | Level I | U.S. Treasury securities and obligations of U.S. government corporations and agencies
Investments:
Fair value	533	333
Restricted deposits: | Level I | Corporate securities
Investments:
Fair value	0	0
Restricted deposits: | Level I | Municipal securities
Investments:
Fair value	0	0
Restricted deposits: | Level I | Cash and cash equivalents
Investments:
Fair value	93	259
Restricted deposits: | Level I | Certificates of deposit
Investments:
Fair value	0	0
Restricted deposits: | Level II
Investments:
Fair value	764	794
Restricted deposits: | Level II | U.S. Treasury securities and obligations of U.S. government corporations and agencies
Investments:
Fair value		0
Restricted deposits: | Level II | Corporate securities
Investments:
Fair value	2	37
Restricted deposits: | Level II | Municipal securities
Investments:
Fair value	758	753
Restricted deposits: | Level II | Cash and cash equivalents
Investments:
Fair value	0	0
Restricted deposits: | Level II | Certificates of deposit
Investments:
Fair value	4	4
Restricted deposits: | Level III
Investments:
Fair value	0	0
Restricted deposits: | Level III | U.S. Treasury securities and obligations of U.S. government corporations and agencies
Investments:
Fair value	0	0
Restricted deposits: | Level III | Corporate securities
Investments:
Fair value	0	0
Restricted deposits: | Level III | Municipal securities
Investments:
Fair value	0	0
Restricted deposits: | Level III | Cash and cash equivalents
Investments:
Fair value	0	0
Restricted deposits: | Level III | Certificates of deposit
Investments:
Fair value	$ 0	$ 0

Fair Value Measurements - Narra

Fair Value Measurements - Narrative (Details) - USD ($) $ in Millions	Dec. 31, 2024	Dec. 31, 2023
Fair Value Disclosures [Abstract]
Aggregate carrying amount of life insurance contracts and equity investments, fair value	$ 1,047	$ 1,007

Property, Software and Equipm_3

Property, Software and Equipment - Schedule of Components (Details) - USD ($) $ in Millions	Dec. 31, 2024	Dec. 31, 2023
Property, Plant and Equipment [Line Items]
Property, software and equipment, at cost	$ 4,870	$ 4,419
Less: accumulated depreciation	(2,803)	(2,400)
Property, software and equipment, net	2,067	2,019
Computer software
Property, Plant and Equipment [Line Items]
Property, software and equipment, at cost	3,051	2,631
Computer hardware
Property, Plant and Equipment [Line Items]
Property, software and equipment, at cost	535	542
Buildings
Property, Plant and Equipment [Line Items]
Property, software and equipment, at cost	523	534
Furniture and office equipment
Property, Plant and Equipment [Line Items]
Property, software and equipment, at cost	332	304
Leasehold improvements
Property, Plant and Equipment [Line Items]
Property, software and equipment, at cost	273	252
Land
Property, Plant and Equipment [Line Items]
Property, software and equipment, at cost	$ 156	$ 156

Property, Software and Equipm_4

Property, Software and Equipment - Narrative (Details) - USD ($)	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Property, Plant and Equipment [Abstract]
Depreciation expense	$ 549,000,000	$ 575,000,000	$ 614,000,000
Property, Plant and Equipment [Line Items]
Remaining asset impairment charges	0	97,000,000	1,627,000,000
Pre-tax gain	0	0	(221,000,000)
Real estate owned and related fixed assets
Property, Plant and Equipment [Line Items]
Impairment charges		$ 57,000,000	$ 1,050,000,000
Property owned
Property, Plant and Equipment [Line Items]
Pre-tax gain	$ 24,000,000

Goodwill and Intangible Asset_2

Goodwill and Intangible Assets - Schedule of Changes in Goodwill by Operating Segment (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023
Goodwill [Roll Forward]
Balance beginning of period	$ 17,558	$ 18,812
Divestitures		(912)
Impairments		(392)
Translation impact		50
Current year activity	0
Balance end of period	17,558	17,558
Medicaid
Goodwill [Roll Forward]
Balance beginning of period	10,198	10,198
Divestitures		0
Impairments		0
Translation impact		0
Current year activity	0
Balance end of period	10,198	10,198
Medicare
Goodwill [Roll Forward]
Balance beginning of period	1,592	1,592
Divestitures		0
Impairments		0
Translation impact		0
Current year activity	0
Balance end of period	1,592	1,592
Commercial
Goodwill [Roll Forward]
Balance beginning of period	5,424	5,424
Divestitures		0
Impairments		0
Translation impact		0
Current year activity	0
Balance end of period	5,424	5,424
Other
Goodwill [Roll Forward]
Balance beginning of period	344	1,598
Divestitures		(912)
Impairments		(392)
Translation impact		50
Current year activity	0
Balance end of period	$ 344	$ 344

Goodwill and Intangible Asset_3

Goodwill and Intangible Assets - Narrative (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Goodwill [Line Items]
Goodwill	$ 17,558	$ 17,558	$ 18,812
Amortization expense	$ 692	718	$ 817
Disposal Group, Held-for-Sale, Not Discontinued Operations | Circle Health
Goodwill [Line Items]
Goodwill		$ 760

Goodwill and Intangible Asset_4

Goodwill and Intangible Assets - Schedule of Intangible Assets (Details) - USD ($) $ in Millions	Dec. 31, 2024	Dec. 31, 2023
Finite-Lived Intangible Assets [Line Items]
Intangible assets	$ 9,698	$ 9,698
Total accumulated amortization	(4,289)	(3,597)
Intangible assets, net	$ 5,409	$ 6,101
Weighted Average Useful Life in Years	13 years 4 months 24 days	13 years 4 months 24 days
Purchased contract rights and customer relationships
Finite-Lived Intangible Assets [Line Items]
Intangible assets	$ 7,845	$ 7,845
Total accumulated amortization	$ (3,348)	$ (2,768)
Weighted Average Useful Life in Years	13 years 6 months	13 years 6 months
Trade names
Finite-Lived Intangible Assets [Line Items]
Intangible assets	$ 943	$ 943
Total accumulated amortization	$ (383)	$ (320)
Weighted Average Useful Life in Years	15 years 7 months 6 days	15 years 7 months 6 days
Provider contracts
Finite-Lived Intangible Assets [Line Items]
Intangible assets	$ 612	$ 612
Total accumulated amortization	$ (271)	$ (227)
Weighted Average Useful Life in Years	14 years	14 years
Developed technologies
Finite-Lived Intangible Assets [Line Items]
Intangible assets	$ 298	$ 298
Total accumulated amortization	$ (287)	$ (282)
Weighted Average Useful Life in Years	4 years 4 months 24 days	4 years 4 months 24 days

Goodwill and Intangible Asset_5

Goodwill and Intangible Assets - Schedule of Future Amortization Expenses (Details) $ in Millions	Dec. 31, 2024 USD ($)
Finite-Lived Intangible Assets, Net, Amortization Expense, Fiscal Year Maturity [Abstract]
2025	$ 690
2026	673
2027	663
2028	662
2029	$ 558

Medical Claims Liability - Sche

Medical Claims Liability - Schedule of Change in Medical Claims Liability (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Liability for Unpaid Claims and Claims Adjustment Expense [Roll Forward]
Balance, January 1	$ 18,000	$ 16,745	$ 14,243
Less: Reinsurance recoverables	49	26	23
Balance, January 1, net	17,951	16,719	14,220
Acquisitions and divestitures			105
Incurred related to:
Current year	128,312	120,680	112,896
Prior years	(2,447)	(2,036)	(1,367)
Total incurred	125,865	118,644	111,529
Paid related to:
Current year	111,456	104,725	97,799
Prior years	13,959	12,937	11,336
Total paid	125,415	117,662	109,135
Plus: Premium deficiency reserve	(158)	250
Balance December 31, net	18,243	17,951	16,719
Plus: Reinsurance recoverables	65	49	26
Balance, December 31	18,308	18,000	16,745
Medicaid
Liability for Unpaid Claims and Claims Adjustment Expense [Roll Forward]
Balance, January 1	10,814	11,253	9,845
Less: Reinsurance recoverables	5	7	23
Balance, January 1, net	10,809	11,246	9,822
Acquisitions and divestitures			0
Incurred related to:
Current year	78,886	79,747	76,344
Prior years	(1,370)	(1,537)	(1,046)
Total incurred	77,516	78,210	75,298
Paid related to:
Current year	69,351	69,904	66,221
Prior years	8,693	8,743	7,653
Total paid	78,044	78,647	73,874
Balance December 31, net	10,281	10,809	11,246
Plus: Reinsurance recoverables	18	5	7
Balance, December 31	10,299	10,814	11,253
Medicare
Liability for Unpaid Claims and Claims Adjustment Expense [Roll Forward]
Balance, January 1	3,612	3,431	2,286
Less: Reinsurance recoverables	0	0	0
Balance, January 1, net	3,612	3,431	2,286
Acquisitions and divestitures			0
Incurred related to:
Current year	21,170	19,487	19,474
Prior years	(575)	(343)	(102)
Total incurred	20,595	19,144	19,372
Paid related to:
Current year	18,036	16,631	16,275
Prior years	2,655	2,582	1,952
Total paid	20,691	19,213	18,227
Plus: Premium deficiency reserve	(158)	250
Balance December 31, net	3,358	3,612	3,431
Plus: Reinsurance recoverables	0	0	0
Balance, December 31	3,358	3,612	3,431
Commercial
Liability for Unpaid Claims and Claims Adjustment Expense [Roll Forward]
Balance, January 1	3,460	1,921	2,014
Less: Reinsurance recoverables	44	19	0
Balance, January 1, net	3,416	1,902	2,014
Acquisitions and divestitures			0
Incurred related to:
Current year	26,548	19,966	14,296
Prior years	(509)	(150)	(204)
Total incurred	26,039	19,816	14,092
Paid related to:
Current year	22,547	16,823	12,556
Prior years	2,492	1,479	1,648
Total paid	25,039	18,302	14,204
Balance December 31, net	4,416	3,416	1,902
Plus: Reinsurance recoverables	47	44	19
Balance, December 31	4,463	3,460	1,921
Other
Liability for Unpaid Claims and Claims Adjustment Expense [Roll Forward]
Balance, January 1	114	140	98
Less: Reinsurance recoverables	0	0	0
Balance, January 1, net	114	140	98
Acquisitions and divestitures			105
Incurred related to:
Current year	1,708	1,480	2,782
Prior years	7	(6)	(15)
Total incurred	1,715	1,474	2,767
Paid related to:
Current year	1,522	1,367	2,747
Prior years	119	133	83
Total paid	1,641	1,500	2,830
Balance December 31, net	188	114	140
Plus: Reinsurance recoverables	0	0	0
Balance, December 31	$ 188	$ 114	$ 140

Medical Claims Liability - Narr

Medical Claims Liability - Narrative (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Insurance [Abstract]
Amounts recorded as an adjustment to premium revenues related to minimum MLR and return of premium programs	$ 243	$ 382	$ 198
Segment Reporting Information [Line Items]
Premium deficiency reserve liability	(158)	250
Medicare
Segment Reporting Information [Line Items]
Premium deficiency reserve liability	$ (158)	$ 250

Medical Claims Liability - Sc_2

Medical Claims Liability - Schedule of Cumulative Incurred and Paid Claims (Details) - Health insurance product line - USD ($) $ in Millions	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Claims Development [Line Items]
Cumulative Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	$ 357,415
Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	339,188
All outstanding liabilities prior to 2022, net of reinsurance	174
Medical claims liability, net of reinsurance	18,401
2022
Claims Development [Line Items]
Cumulative Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	110,394	$ 110,870	$ 112,896
Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	110,097	109,680	97,799
2023
Claims Development [Line Items]
Cumulative Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	118,709	120,680
Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	117,635	104,725
2024
Claims Development [Line Items]
Cumulative Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	128,312
Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	111,456
Medicaid | Operating Segments
Claims Development [Line Items]
Cumulative Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	232,124
Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	221,911
All outstanding liabilities prior to 2022, net of reinsurance	68
Medical claims liability, net of reinsurance	10,281
Medicaid | Operating Segments | 2022
Claims Development [Line Items]
Cumulative Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	74,722	74,861	76,344
Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	74,608	74,125	66,220
Medicaid | Operating Segments | 2023
Claims Development [Line Items]
Cumulative Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	78,517	79,747
Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	77,952	69,904
Medicaid | Operating Segments | 2024
Claims Development [Line Items]
Cumulative Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	78,885
Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	69,351
Medicare | Operating Segments
Claims Development [Line Items]
Cumulative Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	59,206
Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	55,756
All outstanding liabilities prior to 2022, net of reinsurance	66
Medical claims liability, net of reinsurance	3,516
Medicare | Operating Segments | 2022
Claims Development [Line Items]
Cumulative Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	19,027	19,124	19,475
Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	18,942	18,818	16,276
Medicare | Operating Segments | 2023
Claims Development [Line Items]
Cumulative Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	19,008	19,487
Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	18,778	16,631
Medicare | Operating Segments | 2024
Claims Development [Line Items]
Cumulative Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	21,171
Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	18,036
Commercial | Operating Segments
Claims Development [Line Items]
Cumulative Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	60,116
Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	55,740
All outstanding liabilities prior to 2022, net of reinsurance	40
Medical claims liability, net of reinsurance	4,416
Commercial | Operating Segments | 2022
Claims Development [Line Items]
Cumulative Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	13,870	14,110	14,296
Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	13,773	13,963	12,556
Commercial | Operating Segments | 2023
Claims Development [Line Items]
Cumulative Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	19,698	19,966
Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	19,420	16,823
Commercial | Operating Segments | 2024
Claims Development [Line Items]
Cumulative Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	26,548
Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	22,547
Other | Operating Segments
Claims Development [Line Items]
Cumulative Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	5,969
Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	5,781
All outstanding liabilities prior to 2022, net of reinsurance	0
Medical claims liability, net of reinsurance	188
Other | Operating Segments | 2022
Claims Development [Line Items]
Cumulative Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	2,775	2,775	2,781
Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	2,774	2,774	$ 2,747
Other | Operating Segments | 2023
Claims Development [Line Items]
Cumulative Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	1,486	1,480
Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	1,485	$ 1,367
Other | Operating Segments | 2024
Claims Development [Line Items]
Cumulative Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	1,708
Cumulative Paid Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	$ 1,522

Medical Claims Liability - Sc_3

Medical Claims Liability - Schedule of Incurred Claims and Allocated Claims Adjustment Expenses (Details) - Health insurance product line claim in Millions, $ in Millions	Dec. 31, 2024 USD ($) claim	Dec. 31, 2023 USD ($)	Dec. 31, 2022 USD ($)
Claims Development [Line Items]
Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	$ 357,415
Medicaid | Operating Segments
Claims Development [Line Items]
Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	232,124
Medicare | Operating Segments
Claims Development [Line Items]
Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	59,206
Commercial | Operating Segments
Claims Development [Line Items]
Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	60,116
Other | Operating Segments
Claims Development [Line Items]
Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	5,969
2022
Claims Development [Line Items]
Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	110,394	$ 110,870	$ 112,896
Total IBNR Plus Expected Development on Reported Claims	$ 3
Cumulative Paid Claims | claim	638
2022 | Medicaid | Operating Segments
Claims Development [Line Items]
Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	$ 74,722	74,861	76,344
Total IBNR Plus Expected Development on Reported Claims	$ 3
Cumulative Paid Claims | claim	370.9
2022 | Medicare | Operating Segments
Claims Development [Line Items]
Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	$ 19,027	19,124	19,475
Total IBNR Plus Expected Development on Reported Claims	$ 0
Cumulative Paid Claims | claim	204.8
2022 | Commercial | Operating Segments
Claims Development [Line Items]
Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	$ 13,870	14,110	14,296
Total IBNR Plus Expected Development on Reported Claims	$ 0
Cumulative Paid Claims | claim	57.5
2022 | Other | Operating Segments
Claims Development [Line Items]
Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	$ 2,775	2,775	$ 2,781
Total IBNR Plus Expected Development on Reported Claims	$ 0
Cumulative Paid Claims | claim	4.8
2023
Claims Development [Line Items]
Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	$ 118,709	120,680
Total IBNR Plus Expected Development on Reported Claims	$ 383
Cumulative Paid Claims | claim	623.6
2023 | Medicaid | Operating Segments
Claims Development [Line Items]
Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	$ 78,517	79,747
Total IBNR Plus Expected Development on Reported Claims	$ 218
Cumulative Paid Claims | claim	345.6
2023 | Medicare | Operating Segments
Claims Development [Line Items]
Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	$ 19,008	19,487
Total IBNR Plus Expected Development on Reported Claims	$ 102
Cumulative Paid Claims | claim	200.6
2023 | Commercial | Operating Segments
Claims Development [Line Items]
Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	$ 19,698	19,966
Total IBNR Plus Expected Development on Reported Claims	$ 62
Cumulative Paid Claims | claim	72.9
2023 | Other | Operating Segments
Claims Development [Line Items]
Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	$ 1,486	$ 1,480
Total IBNR Plus Expected Development on Reported Claims	$ 1
Cumulative Paid Claims | claim	4.5
2024
Claims Development [Line Items]
Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	$ 128,312
Total IBNR Plus Expected Development on Reported Claims	$ 12,079
Cumulative Paid Claims | claim	641.3
2024 | Medicaid | Operating Segments
Claims Development [Line Items]
Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	$ 78,885
Total IBNR Plus Expected Development on Reported Claims	$ 6,968
Cumulative Paid Claims | claim	300.1
2024 | Medicare | Operating Segments
Claims Development [Line Items]
Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	$ 21,171
Total IBNR Plus Expected Development on Reported Claims	$ 1,724
Cumulative Paid Claims | claim	253
2024 | Commercial | Operating Segments
Claims Development [Line Items]
Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	$ 26,548
Total IBNR Plus Expected Development on Reported Claims	$ 3,211
Cumulative Paid Claims | claim	83
2024 | Other | Operating Segments
Claims Development [Line Items]
Incurred Claims and Allocated Claim Adjustment Expenses, Net of Reinsurance	$ 1,708
Total IBNR Plus Expected Development on Reported Claims	$ 176
Cumulative Paid Claims | claim	5.2

Affordable Care Act - Schedule

Affordable Care Act - Schedule of Receivables (Payables) Related to the Affordable Care Act Programs (Details) - USD ($) $ in Millions	Dec. 31, 2024	Dec. 31, 2023
Affordable Care Act [Abstract]
Risk adjustment receivable	$ 1,434	$ 893
Risk adjustment payable	(1,605)	(2,553)
Minimum medical loss ratio	(688)	(164)
Cost sharing reduction receivable	305	0
Cost sharing reduction payable	$ (74)	$ (114)

Affordable Care Act - Narrative

Affordable Care Act - Narrative (Details) $ in Millions	12 Months Ended
	Dec. 31, 2024 USD ($)
Affordable Care Act [Abstract]
Risk adjustment, decrease to net payable	$ (1,475)
Risk adjustment pre-tax benefit	853
Pricing assumption retroactive compensation	$ 299

Debt - Schedule of Debt (Detail

Debt - Schedule of Debt (Details) - USD ($)	Dec. 31, 2024	Dec. 31, 2023
Debt Instrument [Line Items]
Total senior notes	$ 15,677,000,000	$ 15,675,000,000
Finance leases and other	0	11,000,000
Debt issuance costs	(100,000,000)	(122,000,000)
Total debt	18,533,000,000	17,829,000,000
Less: current portion	(110,000,000)	(119,000,000)
Long-term debt	18,423,000,000	17,710,000,000
Revolving Credit Agreement
Debt Instrument [Line Items]
Credit facility	950,000,000	150,000,000
Term Loan Facility
Debt Instrument [Line Items]
Credit facility	2,006,000,000	2,115,000,000
$2,500 million 4.25% Senior Notes, due December 15, 2027 | Senior Notes
Debt Instrument [Line Items]
Face amount	$ 2,500,000,000
Interest rate stated, percentage	4.25%
Senior notes	$ 2,398,000,000	2,395,000,000
$2,300 million 2.45% Senior Notes, due July 15, 2028 | Senior Notes
Debt Instrument [Line Items]
Face amount	$ 2,300,000,000
Interest rate stated, percentage	2.45%
Senior notes	$ 2,302,000,000	2,303,000,000
$3,500 million 4.625% Senior Notes, due December 15, 2029 | Senior Notes
Debt Instrument [Line Items]
Face amount	$ 3,500,000,000
Interest rate stated, percentage	4.625%
Senior notes	$ 3,277,000,000	3,277,000,000
$2,000 million 3.375% Senior Notes, due February 15, 2030 | Senior Notes
Debt Instrument [Line Items]
Face amount	$ 2,000,000,000
Interest rate stated, percentage	3.375%
Senior notes	$ 2,000,000,000	2,000,000,000
$2,200 million 3.00% Senior Notes, due October 15, 2030 | Senior Notes
Debt Instrument [Line Items]
Face amount	$ 2,200,000,000
Interest rate stated, percentage	3%
Senior notes	$ 2,200,000,000	2,200,000,000
$2,200 Million 2.50% Senior Notes due March 1, 2031 | Senior Notes
Debt Instrument [Line Items]
Face amount	$ 2,200,000,000
Interest rate stated, percentage	2.50%
Senior notes	$ 2,200,000,000	2,200,000,000
$1,300 million 2.625% Senior Notes, due August 1, 2031 | Senior Notes
Debt Instrument [Line Items]
Face amount	$ 1,300,000,000
Interest rate stated, percentage	2.625%
Senior notes	$ 1,300,000,000	$ 1,300,000,000

Debt - Circle Health Debt Refin

Debt - Circle Health Debt Refinancing (Details) £ in Millions, $ in Millions	1 Months Ended	12 Months Ended
	May 31, 2022 USD ($)	Dec. 31, 2024 USD ($)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 USD ($)	Dec. 31, 2023 GBP (£)	May 31, 2022 GBP (£)
Debt Instrument [Line Items]
Debt extinguishment | $		$ 0	$ 0	$ 30
Foreign Line of Credit
Debt Instrument [Line Items]
Revolving credit facility | £					£ 250	£ 250
Debt extinguishment | $	$ 13
Amount drawn on the facility | £					£ 150

Debt - Revolving Credit Facilit

Debt - Revolving Credit Facility and Term Loan Credit Facility (Details) - USD ($)	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Aug. 31, 2021
First year
Line of Credit Facility [Line Items]
Amortization payment percentage			0%
Second year following closing
Line of Credit Facility [Line Items]
Amortization payment percentage			2.50%
Thereafter until maturity
Line of Credit Facility [Line Items]
Amortization payment percentage			5%
Term Loan Facility
Line of Credit Facility [Line Items]
Revolving credit agreement	$ 2,006,000,000	$ 2,115,000,000
Revolving credit facility
Line of Credit Facility [Line Items]
Revolving credit facility	$ 2,000,000,000
Interest rate	0.25%
Uncommitted option, to increase Credit Facility	$ 500,000,000
Ratio of debt to EBITDA, may increase	4
Revolving credit agreement	$ 950,000,000	$ 150,000,000
Revolving credit facility | Maximum
Line of Credit Facility [Line Items]
Interest rate	1.50%
Revolving credit facility | Minimum
Line of Credit Facility [Line Items]
Interest rate	1.125%
Letter of Credit | Line of Credit
Line of Credit Facility [Line Items]
Revolving credit facility	$ 300,000,000
Swing Loan | Line of Credit
Line of Credit Facility [Line Items]
Revolving credit facility	200,000,000
Term Loan Facility | Unsecured Debt
Line of Credit Facility [Line Items]
Revolving credit facility	$ 2,200,000,000

Debt - Debt Repurchase Program

Debt - Debt Repurchase Program (Details) - USD ($)	Dec. 31, 2024	Dec. 31, 2023	Jun. 30, 2022
Debt Disclosure [Abstract]
Debt repurchase program, authorized amount			$ 1,000,000,000
Debt redemption amount	$ 0	$ 0
Remaining amount available under the program	$ 700,000,000

Debt - Letters of Credit & Sure

Debt - Letters of Credit & Surety Bonds (Details) - USD ($) $ in Millions	Dec. 31, 2024	Dec. 31, 2023
Debt Instrument [Line Items]
Fair value of outstanding debt	$ 16,929	$ 16,322
Surety Bond
Debt Instrument [Line Items]
Surety bonds outstanding	844
Letter of Credit
Debt Instrument [Line Items]
Letters of credit outstanding	$ 145
Weighted average interest rate of outstanding borrowings	0.70%

Debt - Schedule of Aggregate Ma

Debt - Schedule of Aggregate Maturities of Debt (Details) $ in Millions	Dec. 31, 2024 USD ($)
Debt Disclosure [Abstract]
2024	$ 110
2025	2,848
2026	2,405
2027	2,300
2028	3,277
Thereafter	7,700
Long-Term Debt, Total	$ 18,640

Leases - Narrative (Details)

Leases - Narrative (Details) - USD ($)	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Lessee, Lease, Description [Line Items]
Operating lease expense	$ 108,000,000	$ 349,000,000
Cash paid for amounts included in the measurement of lease liabilities recorded as operating cash flows	227,000,000	378,000,000
Right-of-use assets obtained in exchange for operating lease liability	69,000,000	40,000,000
Lease liability for leases commenced	69,000,000	40,000,000
Additional operating leases not yet commenced	8,000,000
ROU asset impairments		40,000,000	$ 577,000,000
Remaining asset impairment charges	$ 0	$ 97,000,000	$ 1,627,000,000
Weighted average remaining lease term	7 years 6 months
Weighted average discount rate for operating leases	3.40%
Maximum
Lessee, Lease, Description [Line Items]
Operating lease not yet commenced, term	5 years

Leases - Schedule of ROU Assets

Leases - Schedule of ROU Assets and Liabilities (Details) - USD ($) $ in Millions	Dec. 31, 2024	Dec. 31, 2023
Assets
ROU assets (recorded within other long-term assets)	$ 359	$ 396
Operating Lease, Right-of-Use Asset, Statement of Financial Position [Extensible List]	Other long-term assets	Other long-term assets
Liabilities [Abstract]
Short-term (recorded within accounts payable and accrued expenses)	$ 158	$ 168
Long-term (recorded within other long-term liabilities)	738	880
Total lease liabilities	$ 896	$ 1,048
Operating Lease, Liability, Current, Statement of Financial Position [Extensible List]	Accounts Payable and Accrued Liabilities, Current	Accounts Payable and Accrued Liabilities, Current
Operating Lease, Liability, Noncurrent, Statement of Financial Position [Extensible List]	Other long-term liabilities	Other long-term liabilities

Leases - Schedule of Operating

Leases - Schedule of Operating Lease Maturity (Details) - USD ($) $ in Millions	Dec. 31, 2024	Dec. 31, 2023
Leases [Abstract]
2025	$ 185
2026	157
2027	134
2028	112
2029	98
Thereafter	334
Total lease payments	1,020
Less: imputed interest	(124)
Total lease liabilities	$ 896	$ 1,048

Stockholders' Equity - Narrativ

Stockholders' Equity - Narrative (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2024
Equity [Abstract]
Stock repurchase program, increase to authorized amount	$ 4,000
Stock repurchase program authorized amount		$ 10,000
Remaining authorized repurchase amount		$ 2,230

Stockholders' Equity - Schedule

Stockholders' Equity - Schedule of Share Repurchase Activity (Details) - USD ($) shares in Thousands, $ in Millions	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Equity, Class of Treasury Stock [Line Items]
Total share repurchases	$ 3,141	$ 1,643	$ 3,096
Share repurchase program, excise tax, payable	$ 28	$ 10
Employee Stock Compensation Plan
Equity, Class of Treasury Stock [Line Items]
Income tax withholding (in shares)	1,494	828	1,213
Income tax withholding	$ 114	$ 56	$ 102
Common Stock
Equity, Class of Treasury Stock [Line Items]
Share buybacks (in shares)	41,987	22,886	35,655
Total share repurchases (in shares)	43,481	23,714	36,868
Share buybacks	$ 2,999	$ 1,577	$ 2,994
Total share repurchases	$ 3,113	$ 1,633	$ 3,096
Common Stock | Accelerated Share Repurchase Agreement
Equity, Class of Treasury Stock [Line Items]
Total share repurchases (in shares)			11,600
Accelerated share repurchases agreement, amount			$ 1,000

Statutory Capital Requirement_2

Statutory Capital Requirements and Dividend Restrictions (Details) - USD ($) $ in Millions	Dec. 31, 2024	Dec. 31, 2023
Statutory Capital Requirements And Dividend Restrictions [Abstract]
Statutory capital and surplus	$ 20,258	$ 18,117
Required minimum aggregate statutory capital and surplus	9,083	$ 8,267
Capital and surplus or net worth not available for dividends	$ 9,083

Income Taxes - Schedule of Cons

Income Taxes - Schedule of Consolidated Income Tax Expense (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Income Tax Contingency [Line Items]
Income (loss) from continuing operations before income tax expense (benefit)	$ 4,257	$ 3,598	$ 1,962
Current tax expense
Federal	798	833	1,144
State and local	142	132	261
Foreign	0	1	4
Total current tax expense	940	966	1,409
Deferred tax expense (benefit)
Federal	8	(71)	(514)
State and local	7	33	(126)
Foreign	8	(29)	(9)
Total deferred tax expense (benefit)	23	(67)	(649)
Total income tax expense (benefit)
Federal	806	762	630
State and local	149	165	135
Foreign	8	(28)	(5)
Income tax expense	963	899	760
U.S. Federal
Income Tax Contingency [Line Items]
Income (loss) from continuing operations before income tax expense (benefit)	3,529	3,686	1,938
Foreign
Income Tax Contingency [Line Items]
Income (loss) from continuing operations before income tax expense (benefit)	$ 728	$ (88)	$ 24

Income Taxes - Schedule of Reco

Income Taxes - Schedule of Reconciliation of the Tax Provision at the U.S. Federal Statutory Rate to the Provision for Income Taxes (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Effective Income Tax Rate Reconciliation [Line Items]
Earnings from continuing operations, before income tax expense	$ 4,257	$ 3,598	$ 1,962
Tax provision at the U.S. federal statutory rate	$ 894	$ 756	$ 412
Tax provision at the U.S. federal statutory rate, percent	21%	21%	21%
Global Intangible Low-Taxed Income (GILTI)	$ 44	$ 4	$ 0
Global Intangible Low-Taxed Income (GILTI), percent	1%	0.10%	0%
Tax credits	$ (14)	$ (5)	$ (8)
Tax credit, percent	(0.30%)	(0.10%)	(0.40%)
Changes in valuation allowances	$ (12)	$ (2)	$ (11)
Changes in valuation allowance, percent	(0.30%)	(0.10%)	(0.60%)
Nondeductible compensation	$ 37	$ 29	$ 51
Nondeductible compensation, percent	0.90%	0.80%	2.60%
Nontaxable or nondeductible divestiture (gains) losses	$ (97)	$ (9)	$ 79
Nontaxable or nondeductible divestiture (gains) losses, percent	(2.30%)	(0.30%)	4%
Other nontaxable or nondeductible items	$ (1)	$ (6)	$ 13
Other nontaxable or nondeductible items, percent	0%	(0.20%)	0.70%
Deferred taxes for investments in subsidiaries	$ 0	$ 0	$ 70
Deferred taxes for investments in subsidiaries, percent	0%	0%	3.60%
Excess tax benefit on stock awards	$ (3)	$ (59)	$ (13)
Excess tax benefit on stock awards, percent	(0.10%)	(1.60%)	(0.70%)
Changes in unrecognized tax benefits	$ 24	$ 27	$ 13
Changes in unrecognized tax benefits, percent	0.60%	0.80%	0.70%
State income taxes, net of federal income tax benefit	$ 95	$ 118	$ 72
State income taxes, net of federal income tax benefit, percent	2.20%	3.30%	3.70%
Income tax expense	$ 963	$ 899	$ 760
Income tax rate, percent	22.60%	25%	38.70%
U.S. Federal
Effective Income Tax Rate Reconciliation [Line Items]
Earnings from continuing operations, before income tax expense	$ 3,529	$ 3,686	$ 1,938
United States
Effective Income Tax Rate Reconciliation [Line Items]
Statutory income tax rate differential	$ 142	$ 62	$ 6
Statutory income tax rate differential, percent	3.30%	1.70%	0.30%
Nondeductible goodwill	$ 0	$ 0	$ 56
Nondeductible goodwill, percent	0%	0%	2.90%
Other	$ 9	$ 26	$ 29
Other, percent	0.20%	0.70%	1.50%
Foreign
Effective Income Tax Rate Reconciliation [Line Items]
Earnings from continuing operations, before income tax expense	$ 728	$ (88)	$ 24
United Kingdom
Effective Income Tax Rate Reconciliation [Line Items]
Nondeductible goodwill	$ (34)	$ 83	$ 0
Nondeductible goodwill, percent	(0.80%)	2.30%	0%
Other	$ 12	$ (26)	$ (2)
Other, percent	0.30%	(0.70%)	(0.10%)
Cayman Islands
Effective Income Tax Rate Reconciliation [Line Items]
Other	$ 2	$ (21)	$ (1)
Other, percent	0%	(0.60%)	(0.10%)
Statutory income tax rate differential	$ (142)	$ (62)	$ (6)
Statutory income tax rate differential, percent	(3.30%)	(1.70%)	(0.30%)
Other jurisdictions
Effective Income Tax Rate Reconciliation [Line Items]
Other jurisdictions	$ 7	$ (16)	$ 0
Other jurisdictions, percent	0.20%	(0.40%)	0%

Income Taxes - Schedule of Comp

Income Taxes - Schedule of Components of Income Taxes Paid (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Income Tax Paid, by Individual Jurisdiction [Line Items]
US Federal	$ 930	$ 698	$ 1,009
Total U.S. State and Local	71	191	175
Foreign	1	(2)	14
Total income taxes paid, net	1,002	887	1,198
Tax credits purchased, federal	100	49
Tax credits purchased, State and Local	15	10	19
PENNSYLVANIA
Income Tax Paid, by Individual Jurisdiction [Line Items]
Total U.S. State and Local		53
Other
Income Tax Paid, by Individual Jurisdiction [Line Items]
Total U.S. State and Local	$ 71	$ 138	$ 175

Income Taxes - Schedule of Tax

Income Taxes - Schedule of Tax Effects of Temporary Differences Which Give Rise to Deferred Tax Assets and Liabilities (Details) - USD ($) $ in Millions	Dec. 31, 2024	Dec. 31, 2023
Deferred tax assets:
Medical claims liability	$ 178	$ 217
Nondeductible liabilities	81	111
Net operating loss and tax credit carryforwards	70	71
Compensation accruals	93	113
Premium and trade receivables	72	94
Operating lease liability	231	269
Unrealized gain/loss	153	179
Software development costs	246	193
Other	92	92
Deferred tax assets	1,216	1,339
Valuation allowance	(77)	(82)
Net deferred tax assets	1,139	1,257
Deferred tax liabilities:
Goodwill and intangible assets	1,518	1,603
Fixed assets	135	127
Right-of-use asset	88	98
Other	82	70
Deferred tax liabilities	1,823	1,898
Net deferred tax liabilities	$ (684)	$ (641)

Income Taxes - Narrative (Detai

Income Taxes - Narrative (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023
Operating Loss Carryforwards [Line Items]
Operating loss carryforwards and tax credit carryforwards, not subject to expiration	$ 16
Unrecognized tax benefits that would impact effective tax rate	213
Net interest expense related to uncertain tax positions	13	$ 18
Accrued interest and penalties for uncertain tax position	98	$ 84
U.S. Federal
Operating Loss Carryforwards [Line Items]
Operating loss and tax credit carryforwards	11
State and Local Jurisdiction
Operating Loss Carryforwards [Line Items]
Operating loss carryforwards and tax credit carryforwards, subject to expiration	$ 42

Income Taxes - Schedule of Rese

Income Taxes - Schedule of Reserve for Uncertain Tax Positions That May be Challenged (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023
Unrecognized Tax Benefits [Roll Forward]
Gross unrecognized tax benefits, January 1	$ 439	$ 410
Gross increases:
Current year tax positions	16	19
Prior year tax positions	31	29
Gross decreases:
Settlements	(133)	(2)
Prior year tax positions	(6)	(10)
Statute of limitation lapses	(7)	(7)
Gross unrecognized tax benefits, December 31	$ 340	$ 439

Stock Incentive Plans - Narrati

Stock Incentive Plans - Narrative (Details) - USD ($) shares in Thousands, $ in Millions	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Available for future awards (in shares)	10,000
Accelerated vesting period	1 year
Stock compensation expense	$ 212	$ 216	$ 234
Income tax benefit recognized	26	101	48
Fair value of restricted stock and restricted stock units	317	$ 185	$ 298
Unrecognized compensation cost related to non-vested share-based compensation arrangements granted under the plans	$ 223
Weighted-average period	1 year 10 months 24 days
Employee stock purchase plan issued (in shares)	572	607	449
Stock Options | Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock options, restricted stock and restricted stock unit awards vesting period, years	3 years
Stock Options | Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock options, restricted stock and restricted stock unit awards vesting period, years	5 years
Restricted Stock | Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock options, restricted stock and restricted stock unit awards vesting period, years	1 year
Restricted Stock | Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock options, restricted stock and restricted stock unit awards vesting period, years	3 years
Restricted Stock Units Awards | Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock options, restricted stock and restricted stock unit awards vesting period, years	1 year
Restricted Stock Units Awards | Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock options, restricted stock and restricted stock unit awards vesting period, years	3 years

Stock Incentive Plans - Summary

Stock Incentive Plans - Summary of Non-Vested Restricted Stock and Restricted Stock (Details) shares in Thousands	12 Months Ended
	Dec. 31, 2024 $ / shares shares
Shares
Balance, beginning of period (in shares) | shares	7,462
Granted (in shares) | shares	3,741
Vested (in shares) | shares	(4,196)
Forfeited (in shares) | shares	(655)
Balance, end of period (in shares) | shares	6,352
Weighted Average Grant Date Fair Value
Balance, beginning of period (in usd per share) | $ / shares	$ 68.96
Granted (in usd per share) | $ / shares	76.84
Vested (in usd per share) | $ / shares	69.42
Forfeited (in usd per share) | $ / shares	70.88
Balance, end of period (in usd per share) | $ / shares	$ 73.10

Retirement Plan (Details)

Retirement Plan (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Retirement Benefits [Abstract]
Defined contribution plan covered employee, age (at least)	21 years
Defined contribution plan matching contribution expense	$ 136	$ 131	$ 133

Earnings Per Share (Details)

Earnings Per Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Millions	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Net Income (Loss) Attributable to Parent [Abstract]
Earnings attributable to Centene Corporation	$ 3,305	$ 2,702	$ 1,202
Shares used in computing per share amounts:
Weighted average number of common shares outstanding (in shares)	521,790	543,319	575,191
Common stock equivalents (as determined by applying the treasury stock method) (in shares)	1,954	2,385	6,849
Weighted average number of common shares and potential dilutive common shares outstanding (in shares)	523,744	545,704	582,040
Net earnings per common share attributable to Centene Corporation:
Basic earnings per common share (in usd per share)	$ 6.33	$ 4.97	$ 2.09
Diluted earnings per common share (in usd per share)	$ 6.31	$ 4.95	$ 2.07
Anti-dilutive stock options and restricted stock units excluded from the calculation of diluted earnings per common share (in shares)	278	376	187

Segment Information (Details)

Segment Information (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Segment Reporting Information [Line Items]
Premium and service revenues	$ 145,505	$ 140,095	$ 135,479
Premium tax	17,566	13,904	9,068
Total external revenues	163,071	153,999	144,547
Total revenues	163,071	153,999	144,547
Medical costs	125,707	118,894	111,529
Cost of services	2,729	3,564	7,032
Other operating expense	31,460	28,611	24,668
Other income (expense)	1,082	668	644
Earnings before income tax	4,257	3,598	1,962
Segment Gross margin	17,069	17,637	16,918
Operating Segments
Segment Reporting Information [Line Items]
Total revenues	16,879	16,735	25,191
Eliminations
Segment Reporting Information [Line Items]
Total revenues	(16,879)	(16,735)	(25,191)
Premium
Segment Reporting Information [Line Items]
Premium and service revenues	142,303	135,636	127,131
Service
Segment Reporting Information [Line Items]
Premium and service revenues	3,202	4,459	8,348
Premium and service revenues
Segment Reporting Information [Line Items]
Premium and service revenues	145,505	140,095	135,479
Medicaid
Segment Reporting Information [Line Items]
Total revenues	101,417	100,759	93,151
Medical costs	77,516	78,210	75,298
Cost of services	89	4	0
Segment Gross margin	6,246	8,641	8,785
Medicaid | Operating Segments
Segment Reporting Information [Line Items]
Premium tax	17,566	13,904	9,068
Total external revenues	101,417	100,759	93,151
Total revenues	0	0	0
Medicaid | Eliminations
Segment Reporting Information [Line Items]
Total revenues	0	0	0
Medicaid | Premium | Operating Segments
Segment Reporting Information [Line Items]
Premium and service revenues	83,758	86,853	84,084
Medicaid | Service | Operating Segments
Segment Reporting Information [Line Items]
Premium and service revenues	93	2	(1)
Medicaid | Premium and service revenues | Operating Segments
Segment Reporting Information [Line Items]
Premium and service revenues	83,851	86,855	84,083
Medicare
Segment Reporting Information [Line Items]
Total revenues	23,032	22,261	22,484
Medical costs	20,437	19,394	19,372
Cost of services	0	0	0
Segment Gross margin	2,595	2,867	3,112
Medicare | Operating Segments
Segment Reporting Information [Line Items]
Premium tax	0	0	0
Total external revenues	23,032	22,261	22,484
Total revenues	0	0	0
Medicare | Eliminations
Segment Reporting Information [Line Items]
Total revenues	0	0	0
Medicare | Premium | Operating Segments
Segment Reporting Information [Line Items]
Premium and service revenues	23,032	22,261	22,484
Medicare | Service | Operating Segments
Segment Reporting Information [Line Items]
Premium and service revenues	0	0	0
Medicare | Premium and service revenues | Operating Segments
Segment Reporting Information [Line Items]
Premium and service revenues	23,032	22,261	22,484
Commercial
Segment Reporting Information [Line Items]
Total revenues	33,702	24,845	17,380
Medical costs	26,039	19,816	14,092
Cost of services	0	0	0
Segment Gross margin	7,663	5,029	3,288
Commercial | Operating Segments
Segment Reporting Information [Line Items]
Premium tax	0	0	0
Total external revenues	33,702	24,845	17,380
Total revenues	0	0	0
Commercial | Eliminations
Segment Reporting Information [Line Items]
Total revenues	0	0	0
Commercial | Premium
Segment Reporting Information [Line Items]
Premium and service revenues	33,699	24,843	17,377
Commercial | Service | Operating Segments
Segment Reporting Information [Line Items]
Premium and service revenues	3	2	3
Commercial | Premium and service revenues | Operating Segments
Segment Reporting Information [Line Items]
Premium and service revenues	33,702	24,845	17,380
Other/Eliminations
Segment Reporting Information [Line Items]
Total revenues	4,920	6,134	11,532
Medical costs	1,715	1,474	2,767
Cost of services	2,640	3,560	7,032
Segment Gross margin	565	1,100	1,733
Other/Eliminations | Operating Segments
Segment Reporting Information [Line Items]
Premium tax	0	0	0
Total external revenues	4,920	6,134	11,532
Total revenues	16,879	16,735	25,191
Other/Eliminations | Eliminations
Segment Reporting Information [Line Items]
Total revenues	(16,879)	(16,735)	(25,191)
Other/Eliminations | Premium | Operating Segments
Segment Reporting Information [Line Items]
Premium and service revenues	1,814	1,679	3,186
Other/Eliminations | Service | Operating Segments
Segment Reporting Information [Line Items]
Premium and service revenues	3,106	4,455	8,346
Other/Eliminations | Premium and service revenues | Operating Segments
Segment Reporting Information [Line Items]
Premium and service revenues	$ 4,920	$ 6,134	$ 11,532

Condensed Financial Informati_3

Condensed Financial Information of Registrant - Schedule of Condensed Balance Sheets (Details) - USD ($) $ in Millions	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Current assets:
Cash and cash equivalents	$ 14,063	$ 17,193	$ 12,074
Other current assets	1,601	5,572
Total current assets	37,999	40,756
Long-term investments	17,429	16,286
Other long-term assets	593	535
Total assets	82,445	84,641
Current liabilities:
Current portion of long-term debt	110	119
Total current liabilities	34,261	36,716
Long-term debt	18,423	17,710
Other long-term liabilities	2,567	3,618
Total liabilities	55,935	58,685
Commitments and contingencies
Redeemable noncontrolling interests	10	19
Stockholders' equity:
Preferred stock, $0.001 par value; authorized 10,000 shares; no shares issued or outstanding at December 31, 2024 and December 31, 2023	0	0
Common stock, $0.001 par value; authorized 800,000 shares; 620,195 issued and 495,907 outstanding at December 31, 2024, and 615,291 issued and 534,484 outstanding at December 31, 2023	1	1
Additional paid-in capital	20,562	20,304
Accumulated other comprehensive (loss)	(504)	(652)
Retained earnings	15,348	12,043
Total Centene stockholders' equity	26,410	25,840
Nonredeemable noncontrolling interest	90	97
Total stockholders' equity	26,500	25,937	$ 24,181	$ 26,940
Total liabilities, redeemable noncontrolling interests and stockholders' equity	82,445	84,641
Parent Company
Current assets:
Cash and cash equivalents	7	7
Other current assets	9	7
Total current assets	16	14
Long-term investments	206	264
Investment in subsidiaries	45,148	43,853
Other long-term assets	85	186
Total assets	45,455	44,317
Current liabilities:
Current liabilities	243	417
Current portion of long-term debt	110	110
Total current liabilities	353	527
Long-term debt	18,423	17,708
Other long-term liabilities	169	126
Total liabilities	18,945	18,361
Commitments and contingencies
Redeemable noncontrolling interests	10	19
Stockholders' equity:
Preferred stock, $0.001 par value; authorized 10,000 shares; no shares issued or outstanding at December 31, 2024 and December 31, 2023	0	0
Common stock, $0.001 par value; authorized 800,000 shares; 620,195 issued and 495,907 outstanding at December 31, 2024, and 615,291 issued and 534,484 outstanding at December 31, 2023	1	1
Additional paid-in capital	20,562	20,304
Accumulated other comprehensive (loss)	(504)	(652)
Retained earnings	15,348	12,043
Treasury stock, at cost (124,288 and 80,807 shares, respectively)	(8,997)	(5,856)
Total Centene stockholders' equity	26,410	25,840
Nonredeemable noncontrolling interest	90	97
Total stockholders' equity	26,500	25,937
Total liabilities, redeemable noncontrolling interests and stockholders' equity	$ 45,455	$ 44,317

Condensed Financial Informati_4

Condensed Financial Information of Registrant - Schedule of Condensed Balance Sheets Additional (Details) - $ / shares shares in Thousands	Dec. 31, 2024	Dec. 31, 2023
Preferred stock, par value (in usd per share)	$ 0.001	$ 0.001
Preferred stock, shares authorized (in shares)	10,000	10,000
Preferred stock, shares issued (in shares)	0	0
Preferred stock, shares outstanding (in shares)	0	0
Common stock, par value (in usd per share)	$ 0.001	$ 0.001
Common stock, shares authorized (in shares)	800,000	800,000
Common stock, shares issued (in shares)	620,195	615,291
Common stock, shares outstanding (in shares)	495,907	534,484
Treasury stock, at cost (in shares)	124,288	80,807
Parent Company
Preferred stock, par value (in usd per share)	$ 0.001	$ 0.001
Preferred stock, shares authorized (in shares)	10,000	10,000
Preferred stock, shares issued (in shares)	0	0
Preferred stock, shares outstanding (in shares)	0	0
Common stock, par value (in usd per share)	$ 0.001	$ 0.001
Common stock, shares authorized (in shares)	800,000	800,000
Common stock, shares issued (in shares)	620,195	615,291
Common stock, shares outstanding (in shares)	495,907	534,484
Treasury stock, at cost (in shares)	124,288	80,807

Condensed Financial Informati_5

Condensed Financial Information of Registrant - Schedule of Condensed Statements of Operations (Details) - USD ($) $ / shares in Units, $ in Millions	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Expenses:
Selling, general and administrative expenses	$ 12,400	$ 12,563	$ 11,589
Other income (expense):
Investment and other income	1,784	1,393	1,279
Gain (loss) on divestiture	120	152	772
Debt extinguishment	0	0	30
Interest expense	(702)	(725)	(665)
Income tax (benefit)	963	899	760
Net earnings	3,294	2,699	1,202
Loss attributable to noncontrolling interests	11	3	0
Net earnings attributable to Centene Corporation	$ 3,305	$ 2,702	$ 1,202
Net earnings per common share attributable to Centene Corporation:
Basic earnings per common share (in usd per share)	$ 6.33	$ 4.97	$ 2.09
Diluted earnings per common share (in usd per share)	$ 6.31	$ 4.95	$ 2.07
Parent Company
Expenses:
Selling, general and administrative expenses	$ 13	$ 14	$ 21
Legal settlement	0	0	33
Other income (expense):
Investment and other income	(34)	(47)	55
Gain (loss) on divestiture	(34)	108	13
Debt extinguishment	0	0	14
Interest expense	(700)	(710)	(643)
(Loss) before income taxes	(781)	(663)	(615)
Income tax (benefit)	(76)	(118)	(208)
Net (loss) before equity in subsidiaries	(705)	(545)	(407)
Equity in earnings from subsidiaries	3,999	3,244	1,609
Net earnings	3,294	2,699	1,202
Loss attributable to noncontrolling interests	11	3	0
Net earnings attributable to Centene Corporation	$ 3,305	$ 2,702	$ 1,202
Net earnings per common share attributable to Centene Corporation:
Basic earnings per common share (in usd per share)	$ 6.33	$ 4.97	$ 2.09
Diluted earnings per common share (in usd per share)	$ 6.31	$ 4.95	$ 2.07

Condensed Financial Informati_6

Condensed Financial Information of Registrant - Schedule of Condensed Statements of Cash Flows (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Cash flows from operating activities:
Other operating activities, net	$ 56	$ (4)	$ 125
Net cash provided by operating activities	154	8,053	6,261
Cash flows from investing activities:
Purchases of investments	(7,183)	(6,622)	(6,736)
Net cash used in investing activities	(1,052)	(1,191)	(2,921)
Cash flows from financing activities:
Proceeds from common stock issuances	46	44	70
Proceeds from long-term debt	1,300	2,335	360
Payments and repurchases of long-term debt	(622)	(2,316)	(1,490)
Common stock repurchases	(3,124)	(1,633)	(3,096)
Payments for debt extinguishment	0	0	(14)
Other financing activities, net	(6)	0	(27)
Net cash used in financing activities	(2,406)	(1,658)	(4,197)
Cash, cash equivalents and restricted cash and cash equivalents, beginning of period	17,452	12,330	13,214
Cash, cash equivalents and restricted cash and cash equivalents, end of period	14,156	17,452	12,330
Parent Company
Cash flows from operating activities:
Dividends from subsidiaries, return on investment	1,797	2,823	1,706
Payments for legal settlement	(263)	(326)	(282)
Other operating activities, net	(422)	(334)	(450)
Net cash provided by operating activities	1,112	2,163	974
Cash flows from investing activities:
Capital contributions to subsidiaries	(730)	(443)	(880)
Purchases of investments	(2)	(202)	(2)
Dividends from subsidiaries, return of investment	321	85	10
Investments in acquisitions	0	0	(2,431)
Proceeds from divestitures	0	325	0
Intercompany activities	1,693	(357)	5,785
Other investing activities, net	0	0	3
Net cash used in investing activities	1,282	(592)	2,485
Cash flows from financing activities:
Proceeds from common stock issuances	46	44	70
Proceeds from long-term debt	1,300	2,305	75
Payments and repurchases of long-term debt	(610)	(2,290)	(491)
Common stock repurchases	(3,124)	(1,633)	(3,096)
Payments for debt extinguishment	0	0	(14)
Other financing activities, net	(6)	(2)	0
Net cash used in financing activities	(2,394)	(1,576)	(3,456)
Net increase (decrease) in cash and cash equivalents	0	(5)	3
Cash, cash equivalents and restricted cash and cash equivalents, beginning of period	7	12	9
Cash, cash equivalents and restricted cash and cash equivalents, end of period	$ 7	$ 7	$ 12