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Debt - Narrative (Details)
1 Months Ended 2 Months Ended 3 Months Ended 12 Months Ended
Dec. 31, 2020
USD ($)
bank
Apr. 01, 2020
USD ($)
Oct. 31, 2020
USD ($)
bank
Apr. 30, 2020
USD ($)
Dec. 31, 2019
USD ($)
Dec. 31, 2020
USD ($)
bank
Dec. 31, 2019
USD ($)
Dec. 31, 2018
USD ($)
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   $ 199,000,000 $ 2,000,000 $ 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           8,047,000,000 4,491,000,000 131,000,000  
Payments for debt tender and redemption           3,500,000,000      
Commercial paper $ 1,030,000,000       $ 944,000,000 1,030,000,000 944,000,000    
Interest expense on long-term and short-term debt           1,400,000,000 $ 1,600,000,000 $ 507,000,000  
Commercial Paper                  
Debt Instrument [Line Items]                  
Maximum borrowing capacity $ 4,250,000,000         $ 4,250,000,000      
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      
Revolving Credit Agreement | Letter of Credit                  
Debt Instrument [Line Items]                  
Maximum borrowing capacity $ 500,000,000         $ 500,000,000      
Revolving Credit Agreement | Revolving Credit Facility                  
Debt Instrument [Line Items]                  
Leverage ratio covenant 60.00%         60.00%      
Outstanding balances $ 0         $ 0      
364-day Revolving Credit Agreement, Maturing October 2021 | Revolving Credit Facility                  
Debt Instrument [Line Items]                  
Number of participating banks | bank     23            
Maximum borrowing capacity     $ 1,000,000,000.0            
Credit agreement term     364 days            
Leverage ratio covenant 60.00%         60.00%      
Outstanding balances $ 0         $ 0      
364-day Revolving Credit Agreement, Maturing October 2020 | Revolving Credit Facility                  
Debt Instrument [Line Items]                  
Maximum borrowing capacity     $ 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              
Repayment of short-term debt $ 1,400,000,000                
Senior Notes                  
Debt Instrument [Line Items]                  
Aggregate principal amount                 $ 3,500,000,000