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Consolidated Statements of Cash Flows - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Cash Flows from Operating Activities      
Net income $ 5,372 $ 6,782 [1] $ 5,420 [1]
Adjustments to reconcile net income to net cash provided by operating activities:      
Depreciation and amortization 3,035 2,937 [1] 2,923 [1]
Realized investment losses (gains), net 78 487 [1] (198) [1]
Deferred income tax benefit (1,659) (472) [1] (216) [1]
Loss (gain) on sale of businesses 1,499 (1,662) [1] 0 [1]
Debt extinguishment costs 0 0 [1] 141 [1]
Net changes in assets and liabilities, net of non-operating effects:      
Accounts receivable, net (1,663) (2,237) [1] (2,843) [1]
Inventories (868) (1,055) [1] (557) [1]
Reinsurance recoverable and Other assets (539) 393 [1] (655) [1]
Insurance liabilities 584 (336) [1] 805 [1]
Pharmacy and other service costs payable 2,030 1,760 [1] 1,961 [1]
Accounts payable and Accrued expenses and other liabilities 3,481 1,734 [1] 77 [1]
Other, net 463 325 [1] 333 [1]
NET CASH PROVIDED BY OPERATING ACTIVITIES 11,813 8,656 [1] 7,191 [1] Close
Proceeds from investments sold:      
Debt securities and equity securities 1,078 1,744 [1] 2,030 [1]
Investment maturities and repayments:      
Debt securities and equity securities 972 1,327 [1] 1,628 [1]
Commercial mortgage loans 186 98 [1] 180 [1]
Other sales, maturities and repayments (primarily short-term and other long-term investments) 586 1,039 [1] 1,936 [1]
Investments purchased or originated:      
Debt securities and equity securities (4,334) (2,756) [1] (3,553) [1]
Commercial mortgage loans (118) (161) [1] (327) [1]
Other (primarily short-term and other long-term investments) (1,205) (1,563) [1] (2,554) [1]
Property and equipment purchases, net (1,573) (1,295) [1] (1,154) [1]
Acquisitions, net of cash acquired (447) 0 (1,833) [1]
Divestitures, net of cash sold 13 4,835 [1] (61) [1]
Other, net (332) (170) [1] 97 [1]
NET CASH (USED IN) PROVIDED BY INVESTING ACTIVITIES (5,174) 3,098 [1] (3,611) [1] Close
Cash Flows from Financing Activities      
Deposits and interest credited to contractholder deposit funds 167 164 [1] 153 [1]
Withdrawals and benefit payments from contractholder deposit funds (223) (220) [1] (168) [1]
Net change in short-term debt 1,198 (2,059) [1] 975 [1]
Payments for debt extinguishment 0 0 (136) [1]
Repayment of long-term debt (2,967) (500) [1] (4,578) [1]
Net proceeds on issuance of long-term debt 1,491 0 [1] 4,260 [1]
Repurchase of common stock (2,284) (7,607) [1] (7,742) [1]
Issuance of common stock 187 389 [1] 326 [1]
Common stock dividend paid (1,450) (1,384) [1] (1,341) [1]
Other, net (413) (23) [1] 39 [1]
NET CASH USED IN FINANCING ACTIVITIES (4,294) (11,240) [1] (8,212) [1] Close
Effect of foreign currency rate changes on cash, cash equivalents and restricted cash 16 (86) [1] (65) [1] Close
Net increase (decrease) in cash, cash equivalents and restricted cash 2,361 428 [1] (4,697) [1] Close
Cash, cash equivalents and restricted cash January 1, including held for sale assets [1] 5,976 [2] 5,548 [2] 10,245
Cash, cash equivalents and restricted cash December 31, including held for sale assets [2] 8,337 5,976 [1] 5,548 [1]
Cash and cash equivalents reclassified to assets of businesses held for sale (467) 0 [1] (425) [1]
Cash, cash equivalents and restricted cash and cash equivalents December 31, [2] 7,870 5,976 [1] 5,123 [1]
Supplemental Disclosure of Cash Information:      
Income taxes paid, net of refunds 1,471 1,850 [1] 2,240 [1]
Interest paid $ 1,330 $ 1,229 [1] $ 1,253 [1]
[1] Amounts have been restated to reflect the adoption of Targeted Improvements to the Accounting for Long-Duration Contracts in 2023. See Note 2 to the Consolidated Financial Statements for further information.
[2] Restricted cash and cash equivalents were reported in other long-term investments.