Medical Claims and Related Payables - Schedule Changes in Medical Claims and Related Payables (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2025	Mar. 31, 2024
Liability for Unpaid Claims and Claims Adjustment Expense [Roll Forward]
Medical claims and related payables, beginning of the year	$ 918,395	$ 723,071
Components of incurred costs related to:
Current year	1,369,611	1,427,328
Prior years	32,256	16,514
Incurred cost related to claims	1,401,867	1,443,842
Claims paid related to:
Current year	(421,710)	(316,779)
Prior years	(801,235)	(595,250)
Claims paid related	(1,222,945)	(912,029)
Medical claims and related payables, end of the period	$ 1,097,317	$ 1,254,884