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Borrowings - Narrative (Details) - USD ($) |  | 1 Months Ended | 3 Months Ended | 9 Months Ended
--- | --- | --- | --- | ---
Aug. 15, 2019 | Aug. 31, 2019 | Jul. 31, 2019 | Sep. 30, 2019 | Sep. 30, 2018 | Sep. 30, 2019 | Sep. 30, 2018
Debt Instrument [Line Items] |  |  |  |  |  |  |
Proceeds from debt | $ 3,500,000,000 |  |  |  |  |  |
Proceeds from derivative instruments |  |  | $ 25,000,000 |  |  | $ 25,000,000 | $ (446,000,000)
Net cash flow hedges |  |  | $ 18,000,000 |  |  |  |
Premium paid in excess of debt principal |  | $ 76,000,000 |  |  |  |  |
Debt extinguishment fees |  | 8,000,000 |  |  |  |  |
Gain on write off of unamortized deferred financing premiums |  | 5,000,000 |  |  |  |  |
Loss on early extinguishment of debt |  | $ 79,000,000 |  | $ 79,000,000 | $ 0 | $ 79,000,000 | $ 0
Senior Notes | 2.625% senior notes due August 2024 |  |  |  |  |  |  |
Debt Instrument [Line Items] |  |  |  |  |  |  |
Face amount of debt | $ 1,000,000,000.0 |  |  |  |  |  |
Debt interest rate | 2.625% |  |  | 2.265% |  | 2.265% |
Senior Notes | 3% senior notes due August 2026 |  |  |  |  |  |  |
Debt Instrument [Line Items] |  |  |  |  |  |  |
Face amount of debt | $ 750,000,000 |  |  |  |  |  |
Debt interest rate | 3.00% |  |  | 3.00% |  | 3.00% |
Senior Notes | 3.25% senior notes due August 2029 |  |  |  |  |  |  |
Debt Instrument [Line Items] |  |  |  |  |  |  |
Face amount of debt | $ 1,750,000,000 |  |  |  |  |  |
Debt interest rate | 3.25% |  |  | 3.25% |  | 3.25% |
Senior Notes | 3.125% senior notes due March 2020 |  |  |  |  |  |  |
Debt Instrument [Line Items] |  |  |  |  |  |  |
Debt interest rate |  | 3.125% |  | 3.125% |  | 3.125% |
Aggregate principal of debt extinguished |  | $ 1,300,000,000 |  |  |  |  |
Senior Notes | 4.125% senior notes due 2021 |  |  |  |  |  |  |
Debt Instrument [Line Items] |  |  |  |  |  |  |
Debt interest rate |  | 4.125% |  |  |  |  |
Aggregate principal of debt extinguished |  | $ 328,000,000 |  |  |  |  |
Senior Notes | Senior Notes Issued By Aetna, 4.125%, Due 2021 |  |  |  |  |  |  |
Debt Instrument [Line Items] |  |  |  |  |  |  |
Debt interest rate |  | 4.125% |  |  |  |  |
Aggregate principal of debt extinguished |  | $ 297,000,000 |  |  |  |  |
Senior Notes | 5.45% senior notes due June 2021 |  |  |  |  |  |  |
Debt Instrument [Line Items] |  |  |  |  |  |  |
Debt interest rate |  | 5.45% |  | 5.45% |  | 5.45% |
Aggregate principal of debt extinguished |  | $ 413,000,000 |  |  |  |  |
Senior Notes | 3.35% senior notes due March 2021 |  |  |  |  |  |  |
Debt Instrument [Line Items] |  |  |  |  |  |  |
Debt interest rate |  | 3.35% |  | 3.35% |  | 3.35% |
Aggregate principal of debt extinguished |  | $ 962,000,000 |  |  |  |  |
Senior Notes | 2.125% senior notes due June 2021 |  |  |  |  |  |  |
Debt Instrument [Line Items] |  |  |  |  |  |  |
Debt interest rate |  |  |  | 2.125% |  | 2.125% |
Senior Notes | Outstanding senior notes |  |  |  |  |  |  |
Debt Instrument [Line Items] |  |  |  |  |  |  |
Aggregate principal of debt extinguished |  | 4,000,000,000.0 |  |  |  |  |
Floating Rate Notes | Floating rate notes due March 2020 |  |  |  |  |  |  |
Debt Instrument [Line Items] |  |  |  |  |  |  |
Aggregate principal of debt extinguished |  | $ 723,000,000 |  |  |  |  |

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