CVS Is Splitting in Two

CVS Health is breaking itself up after years of buying up insurers, pharmacy middlemen and doctors' offices, the company says it will split into two separate companies.

What's happening

On November 4, 2026, CVS Health announced it plans to separate into two independent, publicly traded companies. The split is expected to be finished in the first half of 2028.

♦ It's one of the largest corporate breakups in history, and a big about-face. CVS spent years arguing that owning the pharmacy, the insurer and the pharmacy benefit manager (PBM) under one roof was good for patients.

Both new companies will keep the CVS name.

Who gets what

CVS Health (the insurance and benefits side) will include:

• Aetna, the health insurer
• CVS Caremark, the pharmacy benefit manager (PBM)
• CVS Specialty, the pharmacy for expensive specialty drugs
• Oak Street Health and Signify Health, which provide primary care and home visits for older adults

CVS Pharmacy (the store side) will include:

• About 9,000 CVS drugstores
• The mail-order pharmacy
• MinuteClinic walk-in clinics, including virtual visits
• Health100, a new technology business

CVS Pharmacy will be led by Prem Shah.

Why now?

CVS says it's splitting "from a position of strength." CEO David Joyner told investors that separating the businesses will make each team more agile and competitive.

But there's more to the story. Giant health care companies that own insurers, PBMs and pharmacies all at once have been under growing pressure from lawmakers in both parties.

♦ Senators Elizabeth Warren (D-Mass.) and Josh Hawley (R-Mo.) introduced the Patients Before Monopolies Act in December 2024. It would ban a company that owns a PBM or an insurer from also owning a pharmacy, and give violators three years to sell.

Their argument: when the same company owns the PBM that sets drug prices and the pharmacy that fills the prescription, it can steer patients to its own stores and overpay itself. Critics have pointed to markups as high as 38,000% on some expensive specialty drugs.

It's not just Washington. In 2025, Arkansas passed a law barring companies that own a PBM from getting pharmacy permits in the state. 

♦ On July 28, 2025, U.S. District Judge Brian Miller issued a preliminary injunction temporarily blocking the law's implementation.

• CVS has argued that owning every piece makes care simpler, more convenient and cheaper. Some Wall Street analysts like the split too. They point out that CVS's drugstore business has finally returned to growth after years of struggling.

What it means for you

For now, nothing changes. CVS says customers will keep getting their medicine, care and benefits without interruption. The split won't be finished until sometime in 2028.

• If you fill prescriptions at a CVS store, use CVS mail order or visit a MinuteClinic, those will all be part of CVS Pharmacy.

• If you have Aetna insurance, or your drug plan is run by CVS Caremark, those stay with CVS Health.

The catch

♦ The split doesn't untangle everything. CVS Specialty, the pharmacy that fills the most expensive drugs, stays with Caremark and Aetna. That means high-cost specialty drugs will still be tied up with one of the country's largest PBMs and insurers, which is exactly what critics have been complaining about.

Specialty drugs are where the big money is. See our article Specialty Drugs.

What to watch

• Whether Congress moves on the Warren-Hawley bill, and whether it would force CVS to go further.

• Whether other giants like UnitedHealth (Optum Rx) and Cigna (Express Scripts) face the same pressure to break up.

• What happens to your copays and pharmacy network once CVS Pharmacy and Caremark are separate companies. Caremark will have less reason to steer you to CVS stores, which could help independent pharmacies. Or not. We'll see.

For more on how PBMs work, see Prescription Problems.