Medical Claims and Related Payables - Schedule Changes in Medical Claims and Related Payables (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2025	Sep. 30, 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	4,301,370	4,291,930
Prior years	35,221	31,922
Incurred cost related to claims	4,336,591	4,323,852
Claims paid related to:
Current year	(3,267,115)	(3,158,273)
Prior years	(957,756)	(709,936)
Claims paid related	(4,224,871)	(3,868,209)
Medical claims and related payables, end of the period	$ 1,030,115	$ 1,178,714