| USD ($) $ in Millions | LTM | Dec 31, 2025 | Dec 31, 2024 | Dec 31, 2023 | Dec 31, 2022 | Dec 31, 2021 | Dec 31, 2020 | Dec 31, 2019 | Dec 31, 2018 | Dec 31, 2017 | Dec 31, 2016 | Dec 31, 2015 | Dec 31, 2014 | Dec 31, 2013 | Dec 31, 2012 | Dec 31, 2011 | Dec 31, 2010 | Dec 31, 2009 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Operating activities | ||||||||||||||||||
Net earnings | $ 14,912 | $ 12,807 | $ 15,242 | $ 23,144 | ||||||||||||||
Noncash items: | ||||||||||||||||||
Depreciation and amortization | 4,285 | 4,361 | 4,099 | 3,972 | ||||||||||||||
Deferred income taxes | (1,254) | (1,752) | (296) | (245) | ||||||||||||||
Share-based compensation | 1,023 | 971 | 1,018 | 1,059 | ||||||||||||||
Loss on sale of subsidiary and subsidiaries held for sale | 342 | 265 | 8,310 | - | ||||||||||||||
Net gains on dispositions and other strategic transactions | (910) | (910) | (3,333) | - | ||||||||||||||
Other, net | 1,311 | 1,673 | (28) | (505) | ||||||||||||||
Other | - | - | - | - | ||||||||||||||
Net change in other operating items, net of effects from acquisitions and dispositions: | ||||||||||||||||||
Accounts receivable | 2,398 | (764) | (1,437) | (3,114) | ||||||||||||||
Other assets | 557 | (4,606) | (4,140) | (2,444) | ||||||||||||||
Medical costs payable | 1,033 | 5,824 | 2,503 | 3,482 | ||||||||||||||
Accounts payable and other liabilities | 3,297 | 1,665 | 2,463 | 3,516 | ||||||||||||||
Other policy liabilities | - | - | - | - | ||||||||||||||
Unearned revenues | 23 | 163 | (197) | 203 | ||||||||||||||
Cash flows from operating activities | 27,017 | 19,697 | 24,204 | 29,068 | ||||||||||||||
Investing activities | ||||||||||||||||||
Purchases of investments | (19,318) | (17,373) | (27,308) | (18,314) | ||||||||||||||
Sales of investments | 6,771 | 9,288 | 18,514 | 7,307 | ||||||||||||||
Maturities of investments | 8,830 | 8,446 | 9,319 | 9,230 | ||||||||||||||
Cash paid for acquisitions and other transactions, net of cash assumed | (3,873) | (4,509) | (13,408) | (10,136) | ||||||||||||||
Proceeds from Divestiture of Businesses, Net of Cash Divested | - | - | - | - | ||||||||||||||
Purchases of property, equipment and capitalized software | (3,400) | (3,622) | (3,499) | (3,386) | ||||||||||||||
Loans to care providers - cyberattack | - | 0 | (9,033) | - | ||||||||||||||
Repayments of care provider loans - cyberattack | 584 | 1,680 | 4,514 | - | ||||||||||||||
Cash received from dispositions, net | - | 561 | 2,041 | 685 | ||||||||||||||
Originations and purchases of loans | - | (4,795) | - | - | ||||||||||||||
Repayments and maturities of loans | - | 1,980 | - | - | ||||||||||||||
Proceeds from disposal of property, equipment and capitalized software | - | - | - | - | ||||||||||||||
Other, net | 1,476 | (341) | (1,667) | (960) | ||||||||||||||
Cash flows used for investing activities | (11,414) | (8,685) | (20,527) | (15,574) | ||||||||||||||
Financing activities | ||||||||||||||||||
Proceeds from interest rate swap termination | - | - | - | - | ||||||||||||||
Common share repurchases | (1,646) | (5,545) | (9,000) | (8,000) | ||||||||||||||
Cash dividends paid | (8,096) | (7,916) | (7,533) | (6,761) | ||||||||||||||
Interest rate swap termination | - | - | - | - | ||||||||||||||
Share-based compensation excess tax benefit | - | - | - | - | ||||||||||||||
Customer funds administered | 723 | 366 | (1,560) | (521) | ||||||||||||||
Proceeds from common stock issuances | 605 | 827 | 1,846 | 1,353 | ||||||||||||||
Repayments of long-term debt | (5,550) | (3,050) | (3,000) | (2,125) | ||||||||||||||
Dividends paid | - | - | - | - | ||||||||||||||
Proceeds from (repayments of) short-term borrowings, net | (103) | 807 | (151) | 11 | ||||||||||||||
Proceeds from (repayments of) commercial paper, net | - | - | - | - | ||||||||||||||
Proceeds from issuance of long-term debt | 0 | 2,969 | 17,811 | 6,394 | ||||||||||||||
Purchases of redeemable noncontrolling interests | (165) | (165) | (280) | (730) | ||||||||||||||
Checks outstanding in excess of bank deposits | - | - | - | - | ||||||||||||||
Acquisition of noncontrolling interest shares | - | - | - | - | ||||||||||||||
Checks outstanding | - | - | - | - | ||||||||||||||
Other, net | (1,179) | 63 | (1,645) | (1,150) | ||||||||||||||
Cash flows used for financing activities | (15,411) | (11,644) | (3,512) | (11,529) | ||||||||||||||
Effect of exchange rate changes on cash and cash equivalents | 8 | 40 | (61) | 97 | ||||||||||||||
(Decrease) increase in cash and cash equivalents, including cash within businesses held for sale | 200 | (592) | 104 | - | ||||||||||||||
Less: net increase in cash within businesses held for sale | (355) | (355) | (219) | - | ||||||||||||||
Net (decrease) increase in cash and cash equivalents | (11) | (947) | (115) | 2,062 | ||||||||||||||
Supplemental cash flow disclosures | ||||||||||||||||||
Cash paid for interest | 4,030 | 4,030 | 3,594 | 3,035 | ||||||||||||||
Cash paid for income taxes | 3,714 | 3,714 | 4,620 | 6,078 | ||||||||||||||
Supplemental schedule of non-cash investing activities | ||||||||||||||||||
Common stock issued for acquisitions | - | - | - | - |