v3.24.3
Segment Information
 9 Months Ended
Sep. 30, 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, vision and dental services, clinical healthcare, behavioral health, international operations, and corporate management companies, among others. The Company's international businesses, Operose Health Group (Operose Health) and Circle Health, 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 to evaluate all results of operations. The Company does not report total assets by segment since this is not a metric used to allocate resources or evaluate segment performance.

Segment information for the three months ended September 30, 2024, is as follows ($ in millions):
 MedicaidMedicareCommercialOther/EliminationsConsolidated Total
Premium$21,291 $5,643 $8,693 $488 $36,115 
Service25 — — 759 784 
Premium and service revenues21,316 5,643 8,693 1,247 36,899 
Premium tax5,124 — — — 5,124 
Total external revenues26,440 5,643 8,693 1,247 42,023 
Internal revenues— — — 4,290 4,290 
Eliminations— — — (4,290)(4,290)
Total revenues$26,440 $5,643 $8,693 $1,247 $42,023 
Medical costs$19,818 $4,968 $6,957 $458 $32,201 
Cost of services$23 $— $— $669 $692 
Gross margin (1)
$1,475 $675 $1,736 $120 $4,006 
(1)
Gross margin represents premium and service revenues less medical costs and cost of services.

Segment information for the three months ended September 30, 2023, is as follows ($ in millions):
 MedicaidMedicareCommercialOther/EliminationsConsolidated Total
Premium$21,619 $5,430 $6,451 $366 $33,866 
Service— — 2 1,099 1,101 
Premium and service revenues21,619 5,430 6,453 1,465 34,967 
Premium tax3,075 — — — 3,075 
Total external revenues24,694 5,430 6,453 1,465 38,042 
Internal revenues— — — 3,978 3,978 
Eliminations— — — (3,978)(3,978)
Total revenues$24,694 $5,430 $6,453 $1,465 $38,042 
Medical costs$19,607 $4,462 $5,089 $321 $29,479 
Cost of services$— $— $— $856 $856 
Gross margin (1)
$2,012 $968 $1,364 $288 $4,632 
(1)
Gross margin represents premium and service revenues less medical costs and cost of services.
Segment information for the nine months ended September 30, 2024, is as follows ($ in millions):
 MedicaidMedicareCommercialOther/EliminationsConsolidated Total
Premium$62,958 $17,556 $24,977 $1,293 $106,784 
Service68 — 2 2,355 2,425 
Premium and service revenues63,026 17,556 24,979 3,648 109,209 
Premium tax13,057 — — — 13,057 
Total external revenues76,083 17,556 24,979 3,648 122,266 
Internal revenues— — — 12,451 12,451 
Eliminations— — — (12,451)(12,451)
Total revenues$76,083 $17,556 $24,979 $3,648 $122,266 
Medical costs$58,080 $15,690 $18,905 $1,223 $93,898 
Cost of services$66 $— $— $1,975 $2,041 
Gross margin (1)
$4,880 $1,866 $6,074 $450 $13,270 
(1)
Gross margin represents premium and service revenues less medical costs and cost of services.

Segment information for the nine months ended September 30, 2023, is as follows ($ in millions):
 MedicaidMedicareCommercialOther/EliminationsConsolidated Total
Premium$65,741 $16,971 $17,437 $1,255 $101,404 
Service— — 2 3,351 3,353 
Premium and service revenues65,741 16,971 17,439 4,606 104,757 
Premium tax9,782 — — — 9,782 
Total external revenues75,523 16,971 17,439 4,606 114,539 
Internal revenues— — — 11,634 11,634 
Eliminations— — — (11,634)(11,634)
Total revenues$75,523 $16,971 $17,439 $4,606 $114,539 
Medical costs$59,076 $14,354 $13,738 $1,092 $88,260 
Cost of services$2 $— $— $2,601 $2,603 
Gross margin (1)
$6,663 $2,617 $3,701 $913 $13,894 
(1)
Gross margin represents premium and service revenues less medical costs and cost of services.