A healthcare ETF holds companies in one part of the stock market: drug makers, biotech firms, medical equipment makers and health care service providers. The healthcare funds listed in Canada look outside the country: iShares describes XHC as global, BMO’s ZUH holds US health care stocks and TD’s TDOC tracks global companies. What separates them is whether they hold US or global stocks, how they choose and weight them, whether they write covered calls and whether they hedge the currency. This page compares them from the figures each issuer publishes, without picking one.
What does a healthcare ETF hold, and why do the Canadian ones hold US and global stocks?
GICS, the classification MSCI developed with S&P Dow Jones Indices, is one system index providers use to sort companies. In GICS the health care sector has two parts: health care equipment and services, and pharmaceuticals, biotechnology and life sciences. Some indexes use another system: the one behind BMO’s ZUH takes its companies from the health care supersector of a different system, the Industry Classification Benchmark.
As of October 7, 2026, health care was 0.31% of XIC, iShares’ fund that tracks the S&P/TSX Capped Composite Index, and the smallest of the sectors iShares lists for it. The funds in the table below hold companies from the US or from around the world instead.
They also hold them in different ways. Five track an index: XHC, ZUH, TDOC, CHCL.B and LIFE. An index fund aims to follow the performance of its index, and the OSC notes that the index decides how much of each stock the fund holds. XHC doesn’t hold the stocks itself: its fact sheet lists one holding, iShares’ US-listed Global Healthcare ETF (IXJ). Harvest’s HHL holds 20 large health care companies in equal amounts.
A broad US fund already holds some: in XUS, iShares’ S&P 500 fund, health care was 9.08% on the same date. A healthcare fund added to a broad fund raises the share of that one sector further; sector and thematic ETFs covers what that concentration means.
The main healthcare ETFs compared
The table lists the Canadian-listed funds that hold health care stocks and publish an MER, from BMO, iShares, TD, CI, Harvest and Evolve, largest first by the net assets each issuer publishes, with covered-call funds marked. US-listed funds, such as the IXJ fund that XHC holds, are left out; US-listed vs Canadian-listed ETFs compares the two kinds of listing.
| Fund | What it holds | Holdings | Hedged to CAD | MER | Distributions |
|---|---|---|---|---|---|
| HHLHarvest Healthcare Leaders Income ETF | 20 large health care companies, with covered callsWrites covered calls | 20as of September 30, 2026 | Yes | 0.97% | Monthly |
| XHCiShares Global Healthcare Index ETF (CAD-Hedged) | Global health care stocks, held through one iShares ETF | 109stocks, in the ETF it holdsas of October 9, 2026 | Yes | 0.66% | Twice a year |
| LIFEEvolve Global Healthcare Enhanced Yield Fund | An equal-weighted portfolio of 20 global health care companies, with covered callsWrites covered calls | 20as of October 7, 2026 | Yes | 0.64% | Monthly |
| ZUHBMO Equal Weight US Health Care Hedged to CAD Index ETF | US health care stocks, equally weighted | 92as of September 30, 2026 | Yes | 0.39% | Annually |
| TDOCTD Global Healthcare Leaders Index ETF | Global large and mid-cap health care stocks | 120as of October 13, 2026 | Not stated | 0.39% | Quarterly |
| CHCL.BCI Global Healthcare Leaders Index ETF | The 150 largest health care companies worldwide | 151as of February 28, 2026 | No | 0.37%Lowest in group | Quarterly |
| HHLEHarvest Healthcare Leaders Enhanced Income ETF | Harvest HHL (20 large health care companies, with covered calls), bought partly with borrowed moneyWrites covered calls | 20stocks, in the ETF it holdsas of September 30, 2026 | Yes | 2.15% | Monthly |
Issuer-published figures. Holdings counts are each as of the date shown under them. MER as of BMO: the latest audited year (fact sheet of September 30, 2026); CI: June 30, 2026; Evolve: the latest ETF Facts (July 16, 2026); Harvest: June 30, 2026; TD: June 30, 2026; iShares: the latest report (fact sheet of August 2026) (each issuer's latest reported MER). Each ticker links to the issuer's page, which has the current price, holdings, distributions and performance.
“What it holds” is each issuer’s own description. Where the hedged column reads “Not stated”, the issuer’s documents don’t say. There are no return or yield columns: how an ETF did in the past can’t tell you how it will do next, and each ticker links to the issuer’s page with current figures.
How do the funds differ?
US or global. ZUH holds US health care stocks: its index takes only companies incorporated or mainly listed in the United States. XHC, TDOC, CHCL.B and LIFE hold companies from around the world. Harvest describes HHL’s 20 holdings both as global and as US healthcare leaders.
How stocks are chosen and weighted. BMO weights ZUH’s holdings equally to lessen the risk tied to single companies, and Evolve’s LIFE and Harvest’s HHL also hold equal amounts. CHCL.B’s index takes the 150 largest health care companies, and TDOC’s takes large and mid-sized ones. HHL and LIFE each hold 20 companies, while the other index funds hold from 92 (ZUH) to 151 (CHCL.B).
Covered calls. Harvest says HHL generally writes covered calls on up to 33% of its stocks, and Evolve says LIFE may write them on up to 33% of its portfolio. Nova Scotia’s securities regulator says the premiums are paid out as monthly distributions, and that a fund that has sold calls can miss out when its stocks rise; covered-call ETFs explains the trade-off. HHLE holds HHL itself, partly with borrowed money: Harvest says its borrowing generally won’t go above about 33% of the fund’s net asset value.
Hedged or not. BMO, iShares, Evolve and Harvest say ZUH, XHC, LIFE, HHL and HHLE hedge their foreign currency back to Canadian dollars. CHCL.B’s units are unhedged, and Harvest also sells unhedged HHL.B units. On unhedged units, a falling US dollar makes US stocks worth less in Canadian dollars; a hedged fund uses derivatives contracts to offset that, though Vanguard notes the risk can’t be removed entirely. Hedged vs unhedged ETFs explains how it works.
Fees. Among the funds that don’t write calls, MERs run from 0.37% for CHCL.B to 0.66% for XHC, with ZUH and TDOC at 0.39% and 0.39%. LIFE’s MER is 0.64% and HHL’s 0.97%. HHLE’s 2.15% isn’t comparable with the others: Harvest says it includes HHLE’s share of HHL’s expenses. The MER is paid whether the fund gains or loses.
Distributions. HHL, LIFE and HHLE pay monthly, TDOC and CHCL.B quarterly, XHC twice a year and ZUH once a year.
What about biotech ETFs?
In GICS, biotechnology is one industry inside the health care sector, grouped with pharmaceuticals and life sciences tools. MSCI’s definition covers companies that research, develop, make or market products based on genetic analysis and genetic engineering, and leaves out companies using biotechnology with no health care use. So a broad healthcare fund can hold biotech companies alongside drug and device makers: iShares says IXJ, the fund XHC holds, gives access to pharmaceutical, biotech and medical device companies worldwide. For funds listed in the US, see US-listed vs Canadian-listed ETFs.
What don’t healthcare ETFs do?
- They don’t spread your money across the market. A fund invested in one kind of investment may swing more over short periods than a broadly diversified one; see sector and thematic ETFs.
- Unhedged units don’t remove currency risk. The exchange rate can move against you on foreign holdings.
- They don’t avoid foreign withholding tax. A Canadian-listed fund holding US stocks pays US withholding tax, and one that reaches other countries through a US-listed ETF, as XHC does, may pay two layers; see withholding by route.
- Covered-call funds can give up gains. Nova Scotia’s securities regulator notes that a fund that has sold calls can miss out when its stocks rise; see how covered calls work.
- They don’t avoid tax in a non-registered account. A fund set up as a mutual fund trust sends a T3 slip. A return of capital is the part of a fund's distribution that is more than its earnings; it isn't taxed in the year you receive it but reduces the adjusted cost base (ACB) of your units, which generally means a larger capital gain or smaller capital loss when you sell, and if it takes the ACB below zero the negative amount is a capital gain for that year. How ETFs are taxed has the detail.
- They aren’t covered by deposit insurance and can lose money.
Where to go next
Sources
The figures and rules on this page come from these sources, last checked against them between September 25, 2026 and October 13, 2026. How we check facts.
- BlackRock iShares: iShares Core S&P/TSX Capped Composite Index ETF | XIC
- BlackRock iShares: iShares Core S&P 500 Index ETF | XUS | CAD
- BlackRock iShares: iShares Global Healthcare Index ETF (CAD-Hedged) | XHC
- BlackRock iShares: Tax Information Centre - Distributions & Tax FAQs | BlackRock Canada
- BMO Global Asset Management: ZUH - Factsheet
- Canada Revenue Agency: Tax treatment of mutual funds
- CI Global Asset Management: CI Global Healthcare Leaders Index ETF UNHEDGED COMMON UNITS CAD
- Evolve ETFs: Healthcare ETF | LIFE ETF | Healthcare Industry Investment
- Harvest ETFs: HHL | Harvest Healthcare Leaders Income ETF | Harvest ETFs
- Harvest ETFs: HHLE | Harvest Healthcare Leaders Enhanced Income ETF | Harvest ETFs
- TD: TD Global Healthcare Leaders Index ETF (TDOC) | TDAM