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 18, 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

100% reinvested · ex-date convention. Period returns use this fixed assumption, independent of chart settings.

HLTH has outpaced XLV over the shared window since Jul 2026, posting a 15.77% total return against 5.08%. 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	Since Jul 2026
HLTH	15.77%
XLV	5.08%

Total return with all distributions reinvested on the ex-dividend date (a modeling convention, not the cash-settlement date), split-adjusted, as of September 18, 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 start of shared available history — 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	$29.30 as of September 18, 2026	$168.39 as of September 18, 2026
Distribution rate	—	1.56%
Distribution Safety Score™	—	100
Safety-Adjusted Yield	—	1.56%
Expense ratio	0.75%	0.08%
AUM	$8.67M	$43.4B
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	—	0.52
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$3.80B

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$2092B

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 1.56% 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 $43.4B in assets vs $8.67M 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 $13.00/month, at current distribution rates.

HLTH yield—

XLV yield1.56%

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 beta0.52

Fund details

HLTH is managed by Tema ETFs (launched 07/21/2026) with $8.67M in assets. XLV is managed by State Street (launched 12/16/1998) with $43.4B in assets.

HLTH AUM$8.67M

XLV AUM$43.4B

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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 $13.00 per month ($156.00 annually).

Which has performed better historically, HLTH or XLV?

HLTH has outpaced XLV over the shared window since Jul 2026, posting a 15.77% total return against 5.08%. 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 19, 2026.

Overview

HLTH and XLV are both healthcare-focused equity ETFs, but they pursue fundamentally different mandates. HLTH is an actively managed fund that concentrates on companies using artificial intelligence across drug discovery, diagnostics, and healthcare IT. XLV is a passive index tracker that replicates the broad Health Care Select Sector Index, capturing pharmaceutical, medical device, biotech, and healthcare services companies across the S&P 500.

How they differ

The sharpest distinction is strategy: HLTH applies active selection around AI-powered healthcare opportunities, while XLV tracks a fixed index with no manager discretion. This drives a secondary difference in cost and scale — XLV charges 0.08% versus 0.75% for HLTH, and XLV holds $43.4B in assets versus $8.67M for HLTH.

Who each is best for

HLTH: Fits investors who believe AI will reshape healthcare delivery and diagnosis, accept concentrated exposure to a narrower thematic universe, and have a longer time horizon to weather the volatility of emerging healthcare technology adoption.

XLV: Fits investors seeking diversified, low-friction exposure to established healthcare businesses across pharma, biotech, devices, and services, with a preference for quarterly income and minimal tracking error relative to the S&P 500 healthcare sector.

Key risks to know

Concentration and thematic risk (HLTH): A portfolio focused on AI-adoption narratives within healthcare lacks the diversification of a broad sector index. If AI hype cycles cool or regulatory barriers slow adoption, the fund's concentrated bets may underperform.

Sector cyclicality and policy risk (XLV): Healthcare remains exposed to pharmaceutical pipeline failures, FDA approval uncertainty, pricing pressure from policymakers, and reimbursement cuts that can compress valuations across the sector simultaneously.

No income from HLTH: Investors seeking dividend or distribution income will find no cash distributions from HLTH, meaning returns depend entirely on price appreciation.

Bottom line

If you want broad, income-producing healthcare exposure with minimal fees and a 25-year operating history, XLV's index approach and 1.56% yield offer simplicity and scale. If you're convinced AI will disrupt healthcare delivery and can accept thematic concentration risk and no distributions, HLTH targets that specific thesis. Past performance does not predict future results; neither fund's historical returns guarantee future outcomes.

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

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