Medical Claims and Related Payables - Schedule Changes in Medical Claims and Related Payables (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2026	Mar. 31, 2025
Liability for Unpaid Claims and Claims Adjustment Expense [Roll Forward]
Medical claims and related payables, beginning of the year	$ 895,284	$ 918,395
Components of incurred costs related to:
Current year	1,281,895	1,369,611
Prior years	(12,267)	32,256
Incurred cost related to claims	1,269,628	1,401,867
Claims paid related to:
Current year	(436,608)	(421,710)
Prior years	(712,982)	(801,235)
Claims paid related	(1,149,590)	(1,222,945)
Medical claims and related payables, end of the period	$ 1,015,322	$ 1,097,317