ETF Comparison

HLTH vs XLV: Which Is the Better Pick in 2026?

A head-to-head comparison of Tema Healthcare AI ETF and State Street Health Care Select Sector SPDR ETF covering yield, cost, risk, and income potential.

Data updated September 4, 2026

Visual comparison

Key metrics

Projected income on $10K

Projections assume the current yield and share price remain constant. Actual results will vary.

Total returns

HLTH has outpaced XLV over the year to date, posting a 12.63% total return against 11.19%. Figures are total returns: price change plus every distribution reinvested.

Total return and risk statistics by fund. Each row is one fund; each column is one period or statistic.
Symbol	YTD	Since Jul 2026
HLTH	12.63%	12.63%
XLV	11.19%	6.99%

Total return with all distributions reinvested on the ex-dividend date (a modeling convention, not the cash-settlement date), split-adjusted, as of September 4, 2026. YTD and 1Y are cumulative; windows of one year or longer are annualized. “Since Jul 2026” measures every fund from July 21, 2026 — the youngest fund's first trading day — so all funds share one comparison window.

Side-by-side snapshot

Side-by-side snapshot. Each row is one metric; each column is one fund.
Metric	HLTH	XLV
Full name	Tema Healthcare AI ETF	State Street Health Care Select Sector SPDR ETF
Issuer	Tema ETFs	State Street
Last Close	$28.51 as of September 4, 2026	$171.45 as of September 4, 2026
Distribution rate	—	1.53%
Distribution Safety Score™	—	100
Safety-Adjusted Yield	—	1.53%
Expense ratio	0.75%	0.08%
AUM	$7.66M	$44.5B
Distribution frequency	None	Quarterly
Underlying index	—	Health Care Select Sector Index
Objective	Seeks long-term capital appreciation through an actively managed portfolio of companies applying artificial intelligence across healthcare — including AI-driven drug discovery, diagnostics, medical imaging, medical devices, and healthcare IT platforms.	Provide exposure to the fund's underlying index or strategy per issuer materials.
Asset class	Equity	Equity
Inception date	07/21/2026	12/16/1998
Beta	—	0.51
Last dividend	—	$0.656
Ex-dividend date	—	06/22/2026

— Distribution rate, Safety-Adjusted Yield, last dividend, and ex-dividend date are not yet available because HLTH launched July 2026; these fields will populate after the first distribution.

Bottom lineWe won't call this one: HLTH launched July 2026, so there is not yet a track record to compare. Compare the strategy, cost and holdings in the sections above and treat any performance figures for the newer ETF as provisional. What is already clear from the numbers above: the two do not cost the same — XLV charges 0.08% against 0.75% for HLTH, and on funds tracking the same thing that gap compounds every year you hold.

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Tema ETFs

ETFs13

Total AUM$3.74B

ETFs and AUM reflect what Dividend Vision tracks — the issuer's full lineup may be larger.

Tema ETFs is known for offering thematically focused and income-oriented strategies that target specific industries and trends rather than broad market exposure. The issuer's lineup spans both income-generating funds and thematic investments centered on sectors such as defense, healthcare, technology, and infrastructure, with tickers including ARMY, CANC, DSPY, HLTH, LAZR, NASA, and VOLT. Tema's approach appeals to investors seeking targeted exposure to niche market segments, combining specialized industry focus with dividend and yield strategies.

See our curated list of related YouTube videos on HLTH.

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State Street

ETFs179

Total AUM$2124B

ETFs and AUM reflect what Dividend Vision tracks — the issuer's full lineup may be larger.

State Street Global Advisors (SSGA) is one of the largest ETF providers globally, known for its flagship SPDR suite of exchange-traded products that serve both institutional and retail investors across a broad range of asset classes. Their 88-fund lineup spans diverse strategies including sector exposure (Select Sector SPDR), income generation (Income and Select Sector SPDR Premium Income families), commodities (including the widely-held GLD gold ETF), bonds, ESG-focused investments, and thematic allocations, with popular tickers like DIA (Diamonds Trust), FEZ (Eurozone exposure), and JNK (high-yield bonds) among their most recognized funds. The issuer is characterized by its comprehensive coverage across multiple market segments and its emphasis on both traditional index-based products and specialized strategies like covered call income funds and factor-based investing.

See our curated list of related YouTube videos on XLV.

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Quick verdict

HLTH (Tema Healthcare AI ETF) and XLV (State Street Health Care Select Sector SPDR ETF) are both ETFs, but they take different approaches.

XLV currently shows a 1.53% distribution yield. HLTH has not yet established a full distribution history, so a comparable yield figure is not available.

XLV is cheaper with an expense ratio of 0.08% compared to 0.75%.

XLV has $44.5B in assets vs $7.66M for HLTH, but HLTH only launched July 2026 — AUM comparisons will become more meaningful as it builds a track record.

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Deep dive

Yield & income

On a $10,000 investment, HLTH has no reported distribution yield yet, so a monthly income estimate is not available, while XLV would produce $12.75/month, at current distribution rates.

HLTH yield—

XLV yield1.53%

Cost & efficiency

Over 10 years on $10,000, HLTH would cost approximately $750 in fees vs $80 for XLV (simplified, not compounded). The $670.00 difference may be offset by yield or performance.

HLTH ER0.75%

XLV ER0.08%

Strategy & risk

HLTH is an actively managed ETF built around healthcare exposure, while XLV tracks Health Care Select Sector Index with an index approach.

HLTH beta—

XLV beta0.51

Fund details

HLTH is managed by Tema ETFs (launched 07/21/2026) with $7.66M in assets. XLV is managed by State Street (launched 12/16/1998) with $44.5B in assets.

HLTH AUM$7.66M

XLV AUM$44.5B

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Frequently asked questions

Which of HLTH or XLV pays more dividend income?

XLV currently reports a distribution yield, while HLTH has not yet established a full distribution history. A direct income comparison is not yet meaningful — check back once both funds have published several consecutive distributions.

What is the difference between HLTH and XLV?

HLTH (Tema Healthcare AI ETF) is an actively managed ETF built around healthcare exposure, while XLV (State Street Health Care Select Sector SPDR ETF) tracks Health Care Select Sector Index with an index approach. They are issued by Tema ETFs and State Street respectively.

Can I hold both HLTH and XLV?

Yes — nothing prevents holding both. Whether the combination actually diversifies depends on how much the underlying exposures overlap, which isn't fully measurable from the data on this page; review each security's holdings, sector, and strategy before treating them as complementary.

Which has lower fees, HLTH or XLV?

HLTH has an expense ratio of 0.75% while XLV charges 0.08%. Lower fees mean more of your investment returns stay in your pocket over time.

How much income does $10,000 in HLTH vs XLV generate?

At current rates, HLTH has not established a distribution history yet, so a monthly income estimate is not available. The same in XLV would produce about $12.75 per month ($153.00 annually).

Which has performed better historically, HLTH or XLV?

HLTH has outpaced XLV over the year to date, posting a 12.63% total return against 11.19%. Figures are total returns: price change plus every distribution reinvested. Past performance does not guarantee future results.

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HLTH vs XLV — at a glance

Generated September 5, 2026.

Overview

HLTH and XLV are both healthcare equity ETFs, but they pursue fundamentally different strategies. HLTH is an actively managed fund focused on companies applying artificial intelligence across healthcare — drug discovery, diagnostics, imaging, and IT platforms. XLV is a passive index fund tracking the Health Care Select Sector Index, which covers the full breadth of large-cap healthcare stocks (pharmaceuticals, medical devices, healthcare services, biotech). The choice between them hinges on whether you want concentrated exposure to AI-driven healthcare innovation or broad sector representation.

How they differ

The core difference is strategy: HLTH is actively managed and thematically concentrated on AI applications in healthcare, while XLV is passively indexed and covers the entire healthcare sector. HLTH has a higher expense ratio at 0.75% versus 0.08%, reflecting active management and smaller scale — HLTH's $7.66M in assets under management contrasts sharply with XLV's $44.5B. XLV launched 12/16/1998, giving it over two decades of track record, whereas HLTH launched 07/21/2026, making it a nascent fund with 1 month of live performance history.

Who each is best for

HLTH: Fits investors seeking concentrated exposure to the healthcare-AI intersection and willing to accept higher costs and liquidity constraints of a small, active fund in exchange for thematic conviction and potential outperformance in an AI-driven healthcare market.

XLV: Fits investors who want broad, liquid healthcare sector participation with minimal fees, steady modest income, and the ballast of a multi-decade index track record — ideal for those treating healthcare as a defensive sector holding rather than a growth bet.

Key risks to know

Concentration and thematic risk in HLTH: An actively managed fund focused exclusively on AI-driven healthcare carries significant concentration risk. Holdings overlap with broader AI trends, and if AI adoption in healthcare slows or faces regulatory headwinds, the entire portfolio could underperform. Investors are betting on both sector and theme succeeding.

Limited track record and liquidity in HLTH: With $7.66M and only 1 month of history, HLTH has minimal real-world performance data and may face liquidity constraints during market stress or redemptions. Small ETFs can struggle to attract assets and may close.

Sector cyclicality in both: Healthcare is sensitive to drug pricing policy, regulatory changes, and reimbursement rates. Both funds would feel the impact of broad sector headwinds — such as stricter price controls or unfavorable patent rulings.

Active management risk in HLTH: Active funds depend on manager skill. Even focused mandates can underperform their indices during favorable market conditions for passive strategies, and HLTH's short history provides no proof of edge.

Bottom line

If you value exposure to the specific opportunity in AI-applied healthcare and accept higher cost and execution risk, HLTH's thematic focus offers a different angle than broad sector coverage. If you prioritize sector exposure with proven liquidity, a 0.08% cost, and steady 1.53% distributions, XLV's scale and longevity provide a stable foundation. Note that past performance does not predict future results, and HLTH's nascency means its future viability as a fund vehicle remains unproven.

AI-generated analysis for educational purposes only. Verify important details independently; past performance does not guarantee future results.

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