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Debt - Narrative (Details)
1 Months Ended 2 Months Ended 3 Months Ended 9 Months Ended
Apr. 01, 2020
USD ($)
Oct. 31, 2020
USD ($)
bank
Apr. 30, 2020
USD ($)
Sep. 30, 2020
USD ($)
bank
Dec. 31, 2019
USD ($)
Sep. 30, 2019
USD ($)
Sep. 30, 2020
USD ($)
bank
Sep. 30, 2019
USD ($)
Mar. 16, 2020
USD ($)
Debt Instrument [Line Items]                  
Aggregate principal amount of outstanding debt securities under tender offer and optional redemption     $ 3,500,000,000            
Aggregate principal amount of outstanding debt securities repurchased under tender offer     1,500,000,000            
Aggregate principal amount of outstanding debt securities repurchased under optional redemption     2,000,000,000.0            
Loss on repurchase of debt, pre-tax     199,000,000 $ 0   $ 0 $ 199,000,000 $ 0  
Loss on repurchase of debt, after-tax     $ 151,000,000            
Notes issued by Express Scripts, Medco and Old Cigna exchanged for Notes issued by Cigna         $ 12,700,000,000        
Repayment of long-term debt             6,897,000,000 $ 3,340,000,000  
Payments for debt tender and redemption             3,500,000,000    
Commercial paper       $ 1,555,000,000 $ 944,000,000   $ 1,555,000,000    
Commercial Paper                  
Debt Instrument [Line Items]                  
Weighted-average interest rate       0.20%     0.20%    
Revolving Credit Agreement                  
Debt Instrument [Line Items]                  
Number of participating banks | bank       23     23    
Maximum borrowing capacity       $ 3,250,000,000     $ 3,250,000,000    
Amount by which credit facilty amount can be increased       $ 500,000,000     $ 500,000,000    
Amount by which credit facilty term length can be increased             1 year    
Leverage ratio covenant       60.00%     60.00%    
Outstanding balances       $ 0     $ 0    
Revolving Credit Agreement | Letter of Credit                  
Debt Instrument [Line Items]                  
Maximum borrowing capacity       500,000,000     500,000,000    
364-day Revolving Credit Agreement, Maturing October 2021 | Revolving Credit Facility | Subsequent Event                  
Debt Instrument [Line Items]                  
Number of participating banks | bank   23              
Maximum borrowing capacity   $ 1,000,000,000.0              
Credit agreement term   364 days              
364-day Revolving Credit Agreement, Maturing October 2020 | Revolving Credit Facility                  
Debt Instrument [Line Items]                  
Maximum borrowing capacity       $ 1,000,000,000.0     $ 1,000,000,000.0    
Credit agreement term             364 days    
Leverage ratio covenant       60.00%     60.00%    
Outstanding balances       $ 0     $ 0    
364-Day Term Loan | Line of Credit                  
Debt Instrument [Line Items]                  
Aggregate principal amount $ 1,400,000,000                
Credit agreement term 364 days                
Prepayment rate 20.00%                
Senior Notes                  
Debt Instrument [Line Items]                  
Aggregate principal amount                 $ 3,500,000,000