CVS will split off its 9,000 pharmacies from Aetna by 2028

CVS Health will split into two public companies and separate about 9,000 drugstores from Aetna, the company said Nov. 4. It expects to finish in the first half of 2028 and furnished the announcement to the SEC in a Form 8-K the same morning.

One company keeps the CVS Health name. It holds Aetna, the CVS Caremark pharmacy benefit manager, CVS Specialty, Oak Street Health clinics and Signify Health, the in home visit business. David Joyner, now chairman and CEO, will lead it.

The other company is CVS Pharmacy. It gets the stores, the mail pharmacy, MinuteClinic and the Health100 technology business. Prem Shah, now group president, will be CEO.

The Financial Times first reported the plan Nov. 3, CNBC noted. The breakup partly undoes the $78 billion Aetna purchase CVS made in 2018, CNBC reported.

Shareholders will own stock in both companies, and CVS intends the split to be tax free.

The quarter behind it

CVS also posted third quarter results on Nov. 4. Revenue rose 5.4% to $108.4 billion. Adjusted earnings were $2.09 a share, up from $1.60 a year earlier. CVS raised its full year adjusted earnings forecast to at least $8.20 a share, from a range of $7.90 to $8.10.

Aetna drove the gain. Its medical benefit ratio, the share of premiums spent on care, fell to 91.3% from 92.8%. CVS credited its government business, which includes Medicare.

The store segment, Pharmacy & Consumer Wellness, booked $35.5 billion in quarterly revenue, down 2.0%. Its adjusted operating income rose 10.6% to $1.6 billion.

What it means for Aetna Medicare members

Nothing changes yet. CVS says customers, patients and clients will keep getting their medicine, care, benefits and services without interruption. The company will run as it does today until the split closes.

Aetna had 4,229,000 Medicare Advantage members on Sept. 30, down 37,000 from a year earlier, plus 3,858,000 people in standalone drug plans, per the quarterly release. CVS says more than 69% of its Medicare Advantage members are in 2027 plans rated 4 stars or higher. It is also suing CMS over its 2027 star ratings, saying more than $2 billion is at stake.

Caremark stays with Aetna, so the drug benefit and the pharmacy benefit manager remain under one roof. The storefronts leave. As a standalone company, CVS Pharmacy says it will pursue partnerships with payers, pharmacy benefit managers and drugmakers.

Open enrollment runs Oct. 15 to Dec. 7, per Medicare.gov. Members picking a 2027 plan should check its pharmacy network as usual. The split is not expected to close before 2028.

The state laws aimed at ownership

States are moving against companies that own pharmacies and pharmacy benefit managers at once.

Arkansas passed Act 624 in 2025. It bars pharmacy benefit managers from holding pharmacy permits in the state, effective Jan. 1, 2026.

A federal judge blocked it with a preliminary injunction. The appeal, Express Scripts v. Richmond, was argued at the Eighth Circuit on Sept. 22, 2026, and the docket shows no decision yet.

Tennessee went further in May. Its FAIR Rx Act, Public Chapter 1111, bars any company from owning more than 5% of a pharmacy while also owning both a health insurer and a pharmacy benefit manager, starting July 1, 2028. A pharmacy pursuing a sale can keep operating through Dec. 31, 2028.

Aetna plus Caremark is that pairing. CVS did not tie the split to either law. A Leerink Partners analyst wrote that the move could also help CVS avoid “relentless state legislative scrutiny” of its vertical integration, CNBC reported.

What to watch

The split still needs final approval from the CVS board, an effective Form 10 registration with the SEC and confirmation of its tax free treatment. Leadership and board names for both companies come later. Also watch the Eighth Circuit ruling on Arkansas’s law and Tennessee’s July 1, 2028 deadline, which lands right after CVS’s target window.