What is XLV and what does it track?

State Street Health Care Select Sector SPDR ETF (XLV) is an exchange-traded fund focused on the Health sector, managing $43.12B in assets. The fund has been trading since 1998-12-16. In seeking to track the performance of the index, the fund employs a replication strategy. It generally invests substantially all, but at least 95%, of its total assets in the securities comprising the index. The index i...

How large is XLV and what does it cost to hold?

XLV currently manages $43.12B in assets. The annual expense ratio (TER) is 0.08%, deducted directly from fund assets. Portfolio turnover stands at 2%, reflecting how frequently holdings are replaced within a year. Lower expense ratios compound favorably over time – a 0.08% TER on a 10-year holding period adds up to meaningfully less drag than a 0.5% fund.

What are the largest holdings in XLV?

XLV allocates 99.6% of its portfolio to Healthcare. The three largest holdings are LLY (14.4%), JNJ (10.7%), ABBV (7.2%). Concentration in the top holdings means single-name events in these positions can have an outsized effect on the ETF's price.

Does XLV pay dividends or distributions?

XLV currently distributes a yield of 1.57%. ETF distributions are typically passed through from dividends and interest generated by the underlying holdings. The actual payout frequency depends on the fund structure – most sector ETFs distribute quarterly.

What is XLV's historical performance?

Reported performance for XLV: year-to-date 3.51%, 3-year cumulative 6.36%, 5-year cumulative 6.18%. Past performance is not indicative of future results. Returns reflect price changes only and may differ from total return figures that include distributions.

What is the current trend signal for XLV?

As of the most recent session, XLV closed at $168.81. The swing trend is negative with ADX at 9.8 (weak trend strength). Momentum is bearish and has been running for 4 trading days. A Golden Cross is in place All data is updated once per trading day after the US market closes.

When was the last Trendchange signal for XLV?

The most recent Trendchange signal for XLV fired on 22.05.26 at $149.89. The position has been open for 19 trading days. Performance after 10 days: +2.08%. The system's historical edge across 88 tracked signals is -2.89%. Trendchange signals are based on proprietary moving average crossover logic applied to end-of-day price data.

XLV – State Street Health Care Select Sector SPDR ETF

ETF

Health | Inception: 1998-12-16

Quick Stats

Trend Signal

$168.81

Last Close

Official EOD price – basis for all calculations

▼ Short

Swing Trend

Moving average structure confirms downtrend – bears in control

-2.89%

Signal Edge

Negative edge across 2 signals – current market regime unfavorable for this signal

9.8

Trend Strength (ADX)

Weak / ranging – trend signals less reliable

Options Signals

19%

IV-Rank (52w)

Options are historically cheap – premium buying favored

81% / 19%

Call / Put Flow

Bullish positioning – call premium dominates options flow

Last Trendchange Signal

22.05.26

Date

Signal entry date

$149.89

Entry Price

Closing price at signal date

19d

Days Held

Trading days since signal

+2.08%

+10d

Return after 10 trading days

-0.33%

+20d

Return after 20 trading days

-0.33%

+30d

Return after 30 trading days

-0.33%

+60d

Return after 60 trading days

Trend Overview

EMA21 Cross – Directional Shift Composite Score: -3 / 7

XLV has just crossed the 21-day EMA at $167.40, now trading above the line. Bulls have reclaimed a key reference. Whether this becomes a sustained move or a failed breakout depends on momentum confirming in the sessions ahead.

What to watch

The cross is a signal, not a confirmation. Watch for a successful retest of the EMA21 from above – that would be the higher-confidence entry.

Options Signal Highlight

MEDIUM Strength 6.5 Long Call 📖 View full options analysis →

XLV Price Chart

Technical Trend Analysis

As of 07.10.2026 · Close: $168.81 · ATR14: $1.48

EMA21 Cross – Directional Shift Composite Score: -3 / 7

What to watch

The cross is a signal, not a confirmation. Watch for a successful retest of the EMA21 from above – that would be the higher-confidence entry.

Indicator	Signal	Detail
Swing Trend	▼ Short	Primary directional bias
Momentum	▼ Down · -4d	Strength: -0.03 – Rising
Trend Strength (ADX)	9.8 – Weak	ADX38: 3.8
Volatility (HV30)	13.3% – Calm	HV90: 18.0% \| HV180: 16.6%
Vola Compression	None	Normal range
MA Structure	Golden Cross ✓	Stack: Mostly aligned (2/3)
EMA21 Distance	~0 ATR – Near line	EMA21: $167.40
GD200 Extension	5.1 ATR – Normal	GD20: 0.2 \| GD50: 0.0 \| GD100: 2.8

📉 Downside Momentum Intensifying

Downward momentum active for -4 days and still building (-0.03). Selling pressure is not easing.

⚪ Trend Strength – ADX14: 9.8 (Weak)

Weak or ranging market. ADX38: 3.8. Trend-following signals carry lower reliability.

🔻 Volatility Calm

HV30: 13.3% | HV90: 18.0% | HV180: 16.6%. Short-term vol is below its 90-day average. Calmer conditions favour tighter setups.

⭐ Golden Cross – Long-term Bullish

Golden Cross in place. GD50 $168.73 above GD200 $156.91 by 7.53%. Long-term structure is bullish. MA stack: Mostly aligned (2/3).

⚡ EMA21 – Fresh Cross

Price has just crossed the 21-day EMA at $167.40, now trading above. Often marks a near-term directional shift.

📐 Key Price Levels & ATR Distance

GD20: $168.29 (0.2 ATR) | GD50: $168.73 (0.0 ATR) | GD100: $161.99 (2.8 ATR) | GD200: $156.91 (5.1 ATR). ATR14: $1.48.

Monthly Performance History

Year	Jan	Feb	Mar	Apr	May	Jun	Jul	Aug	Sep	Oct	Nov	Dec	Total
2010	-1.04	-0.19	1.36	-4.43	-6.96	-1.23	2.18	-3.47	6.05	2.23	-2.89	2.11	-0.35
2011	-0.35	1.30	2.16	5.89	1.43	-0.22	-5.12	-0.42	-4.37	9.24	2.92	2.24	9.12
2012	1.88	0.08	3.41	-0.61	-3.98	7.04	0.68	1.12	3.08	-0.82	-0.30	-0.67	13.49
2013	5.51	0.46	4.96	2.73	2.73	-1.57	6.87	-4.13	2.12	3.01	4.03	0.29	36.32
2014	1.51	8.35	-0.86	-1.26	2.64	1.60	-1.12	4.76	0.13	6.37	3.36	-1.53	24.03
2015	0.93	3.70	-0.54	-0.08	3.11	-1.13	1.86	-7.89	-3.51	6.64	-2.40	-0.39	4.95
2016	-6.02	-0.51	0.19	1.81	1.65	0.14	4.21	-3.86	-0.63	-6.51	T 2.61	1.01	-2.53
2017	T 0.97	5.43	-1.82	1.45	T 0.54	3.02	0.64	T 1.98	0.62	-1.76	T 2.66	-0.74	18.38
2018	5.37	-4.53	-1.69	3.41	T 0.23	0.12	6.22	4.31	3.38	-7.24	T 6.74	-9.33	3.47
2019	T 6.42	0.99	-1.29	-2.86	T -2.04	5.89	-2.11	-0.72	T 0.07	T 6.16	4.87	2.84	19.55
2020	-2.93	T -7.43	-8.63	T 17.04	5.29	-1.88	T 4.65	1.54	-1.69	T -3.29	6.04	2.51	11.07
2021	1.84	-2.48	T 2.33	4.24	0.73	3.60	4.00	2.18	-5.88	T 5.10	-2.94	8.80	24.74
2022	-5.89	-1.23	T 6.00	-5.63	2.12	-1.60	T 2.10	-5.07	-4.49	T 7.40	4.66	-2.56	-2.57
2023	-1.55	-5.09	1.97	T 2.00	-4.76	T 3.16	1.91	-0.18	-3.62	-3.13	T 5.22	3.45	0.68
2024	1.15	1.84	0.95	-4.19	T 2.22	0.72	3.24	4.00	-1.84	-4.14	-0.22	-6.51	-0.87
2025	T 6.73	1.01	-2.39	-2.00	-2.93	T 1.56	T -4.59	T 4.80	1.17	0.54	9.14	-0.32	12.49
2026	-0.50	T 2.90	-7.52	-1.18	T 2.97	7.32	1.89	5.12	-1.89	1.57			8.55

T A T badge marks a Trendchange signal in that month. Hover for entry price.

XLV - Trendchange Chart

Trendchange Signal History

The last 10 Trendchange signals for XLV:

Date	Entry Price	Days Held	+10d	+20d	+30d	+60d
22.05.26	$149.89	19d	+2.08%	-0.33%	-0.33%	-0.33%
20.02.26	$156.82	12d	+0.15%	+0.15%	+0.15%	+0.15%
15.08.25	$136.21	22d	+0.16%	+1.39%	+0.79%	+0.79%
28.07.25	$135.29	1d	-0.81%	+0%	+0%	+0%
12.06.25	$136.81	3d	-2.61%	-2.61%	-2.61%	+0%
23.01.25	$144.08	16d	+3.03%	+1.6%	+1.6%	+1.6%
15.05.24	$146.20	12d	-2.41%	-2.41%	-2.41%	-2.41%
16.11.23	$128.51	55d	+2.18%	+5.29%	+6.12%	+13.56%
15.06.23	$132.22	11d	-0.64%	-1.29%	-1.29%	-1.29%
05.04.23	$133.19	20d	+0.57%	-1.11%	-1.11%	-1.11%

Signal Statistics - Historical Edge

Calculated edge for XLV: -2.89%

Range	N	10d	20d	30d	60d	Signal
7-10%	2	+7.86%	+7.36%	+6.82%	+6.82%	Close
5-7%	1	+5.04%	+3.84%	+4.73%	+4.73%	Close
3-5%	11	+3.6%	+3.9%	+5.14%	+4.89%	Close
1-3%	21	+1.86%	+2%	+2.25%	+2.59%	Hold
0-1%	19	+0.53%	+1.1%	+1.51%	+1.91%	Hold
-1-0%	16	-0.57%	-1.02%	-1.07%	-0.66%	Neg
-3-1%	15	-1.77%	-1.45%	-1.09%	-0.72%	Neg
-5-3%	2	-3.16%	-2.53%	-2.53%	-0.88%	Neg
-7-5%	1	-5.61%	-3.34%	-3.34%	-3.34%	Neg

Exit Rules: Stoploss: -10% | Close if below 0% after 10 days

Signal data as of October 7, 2026

MEDIUM ALERT ● Neutral Strength: 6.5

Options Metrics

IV-Rank (52w)

19%

Bottom 20% of the past 52 weeks – options are historically cheap. Conditions favor premium buyers (Long Call, Long Put).

Call / Put Flow

81% / 19%

More than 60% of options premium is flowing into calls. This indicates net bullish positioning by market participants.

GEX (Mio.)

2,926,509.0

Positive GEX: market makers are long gamma. They buy dips and sell rallies, which suppresses volatility and keeps price in a range.

GEX Flip Strike

$167.00 · 1.1%

GEX flip strike is very close to spot price. Crossing this level can trigger a regime change – from suppressed to amplified volatility.

Max Pain

$167.50 · 0.8%

Max Pain is the price at which the most options contracts expire worthless. As expiration approaches, price often gravitates toward this level due to dealer hedging flows.

Spot Price

$168.81

Last traded price at signal calculation time

Gamma Exposure Timeline

Key GEX levels, Max Pain, and unusual activity across weekly and monthly expirations, plotted around the current spot price.

XLV GEX timeline showing put/call gamma pins, max pain and flip strike

Key GEX levels, Max Pain, Anchor, Ceiling and unusual activity across 14-30 DTE, plotted around the current spot price.

Put and call pins mark strikes where dealer gamma exposure concentrates. The GEX flip strike is where dealer hedging shifts from stabilizing (positive gamma) to amplifying (negative gamma) price moves. Max Pain is the strike where the most options expire worthless. Dashed markers flag unusual options activity. Learn how to use these signals in our options strategy guides →

Strategy Setups – You Decide

Based on current options data, 2 setups match the current conditions. Each strategy has different risk/reward characteristics – the final decision is always yours.

Setup 1 of 2 Long Call Full guide →

Why this fits today

IV-Rank at 19% – options are historically cheap. Bullish flow (81% calls) supports buying upside premium at below-average cost.

Advantages

✓ Unlimited upside potential with maximum loss capped at the premium paid

✓ Low IV-Rank means you are buying at historically cheap levels

✓ Benefits from both a price increase and a subsequent rise in implied volatility

Risks

✕ Time decay (theta) works against the position every day

✕ Requires a meaningful move to overcome the premium paid

✕ Full premium is lost if the stock stays below the strike at expiration

▶ FAQ: Long Call

What is a Long Call?

A Long Call gives the buyer the right to purchase the underlying at the strike price before expiration. The maximum loss is limited to the premium paid. It expresses a bullish directional view and profits if the underlying rises significantly above the strike price.

Why buy calls when IV-Rank is low?

Low IV-Rank means implied volatility is historically cheap - options are priced below their typical levels. Buying premium when it is cheap reduces the hurdle rate for profitability. If IV subsequently rises, the option gains value from both the price move and the increase in implied volatility.

What is the breakeven on a Long Call?

The breakeven equals the strike price plus the premium paid. For example, a call with a $100 strike bought for $3 breaks even at $103. Above that level, the position profits dollar-for-dollar with the stock. Below the strike at expiration, the full premium is lost.

Setup 2 of 2 Long Straddle Full guide →

Why this fits today

IV-Rank at 19% – buying both sides is cost-effective. A subsequent vol expansion or large move benefits both legs simultaneously.

Advantages

✓ Profits from any large directional move without needing to pick a side

✓ Buying when IV is historically cheap reduces the breakeven hurdle

✓ An unexpected vol expansion benefits both the call and put simultaneously

Risks

✕ Requires a significant move to recover the combined premium paid

✕ Theta decay accelerates as expiration approaches

✕ If the stock stays flat, both legs expire worthless

▶ FAQ: Long Straddle

What is a Long Straddle?

A Long Straddle buys a call and a put at the same strike and expiration. It profits from a large move in either direction. When IV is low, the premium cost is reduced, making the breakeven easier to reach on a directional move.

Why buy a straddle when IV is low?

Low IV means you are buying the options cheaply. If IV subsequently rises - due to an event or a directional move - both legs can gain value simultaneously, giving you a double benefit. The key is entering before the vol expansion.

All setups above are personal trade journal observations derived from options flow data. This is not financial advice. The decision to trade, and which strategy to use, is entirely yours.

View full options flow data and historical signals on the Options Flow Analysis Overview →

About State Street Health Care Select Sector SPDR ETF

In seeking to track the performance of the index, the fund employs a replication strategy. It generally invests substantially all, but at least 95%, of its total assets in the securities comprising the index. The index includes companies from the following industries: pharmaceuticals; health care equipment & supplies; health care providers & services; biotechnology; life sciences tools & services; and health care technology. The fund is non-diversified.

Fund Overview

Metric	Value
Assets under Management	$43.12 B
Expense Ratio	0.08%
Dividend Yield	1.57%
Portfolio Turnover	2%
YTD Return	3.51%
3-Year Return	6.36%
5-Year Return	6.18%

Sector Allocation

Sector	Weight
Healthcare	99.6%

Top 10 Holdings

Symbol	Company	Weight
LLY	ELI LILLY AND CO	14.36%
JNJ	JOHNSON & JOHNSON	10.71%
ABBV	ABBVIE INC	7.15%
MRK	MERCK & CO INC	5.24%
UNH	UNITEDHEALTH GROUP INC	4.73%
AMGN	AMGEN INC	3.6%
ABT	ABBOTT LABORATORIES	3.49%
GILD	GILEAD SCIENCES INC	3.29%
TMO	THERMO FISHER SCIENTIFIC INC	3.23%
ISRG	INTUITIVE SURGICAL INC	3.13%

Frequently Asked Questions – State Street Health Care Select Sector SPDR ETF (XLV)

Disclaimer: All trade history on this page reflects the author's personal trading activity only. This is not financial advice. Past performance is not indicative of future results. See our full Disclaimer.