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Head to head · FHIR servers · October 2026 research run

1upHealth vs Terra API

Terra API scores 65.9 (B) on agent readiness against 1upHealth's 46.8 (D), and leads in 5 of 7 scored categories. 1upHealth leads on transparency & trust. Both do fhir servers.

Best health record and wellness data APIs for AI agents · All 63 health comparisons

1upHealth1upHealth, Inc. · HTTP API D46.8/100#903 of 1076 Terra APITerra Enabling Developers Inc. · HTTP API B65.9/100#327 of 1076

Which one, for what

1upHealth D

Best for Consumer and care apps that read a member's health plan claims and clinical data under the CMS rules, and payers meeting those rules.

Ahead on

  • Transparency & trust, 72 against 56

Watch for

No rate limits, 429 handling or error formats documented

Terra API B

Best for A fitness, wellness, insurance or research product whose users connect consumer wearables and apps, and an agent that needs to read one user's sleep, activity or body data through MCP.

Ahead on

  • Reliability, 67 against 52
  • Schema & documentation, 89 against 50
  • Agent ergonomics, 78 against 32
  • Maintenance & community, 75 against 37

Also in its favour

  • A hosted endpoint, with nothing to install

Watch for

No free tier. Sign-up asks for a plan and billing details, and Quick Start starts at $499 a month with a 30-day money-back guarantee

Score by category

CategoryWeight this run1upHealthTerra APIEdge
Reliability16%205267Terra API +15
Performance10%pendingpendingpendingnot scored in this run
Schema & documentation13%16.25089Terra API +39
Agent ergonomics13%16.23278Terra API +46
Security & auth14%17.56365Terra API +2
Payments & pricing10%12.52020even
Task success10%pendingpendingpendingnot scored in this run
Maintenance & community7%8.83775Terra API +38
Transparency & trust7%8.872561upHealth +16
Negative events≤1500
TotalD 46.8/100B 65.9/100

Facts side by side

Fact1upHealthTerra API
KindHTTP APIHTTP API
Vendor1upHealth, Inc.Terra Enabling Developers Inc.
Hosted endpointno (local only)https://access.tryterra.co/api/v2/mcp/<user_id>
TransportsHTTPHTTP, Streamable HTTP
AuthOAuthOAuth or key
PricingPaidPay per use
x402nono
LicenceProprietary service under 1upHealth's Terms of Service (effective 1 August 2024)Proprietary service under Terra's terms of service. The OpenAPI specs repository is Apache 2.0
Tools exposednone6
Read-only variant documentednono
llms.txtyesyes
Last releasenone2026-10-13
Terms last updatedno date given2026-05-01
Privacy policy last updated2026-06-252023-04-20
Customer content may train modelsnot found in the textnot found in the text
Terms restrict automated accessnot found in the textnot found in the text
Terms restrict benchmarkingyesyes
Terms or service can change without noticenot found in the textyes
Arbitration or class-action waivernot found in the textyes
Popularitynone13k npm/wk, 11k PyPI/wk

Verdicts

1upHealth

Self-serve Dev Portal sandbox clients and a demo health plan let an app test the CMS Patient Access, Provider Access and Payer-to-Payer FHIR APIs, backed by HITRUST and SOC 2 Type 2. No rate limits, error formats or dated releases are documented, and the Patient Access OAuth step needs the member in a browser.

Terra API

Graded on the Unified API and the Terra AI MCP server. A public OpenAPI 3.1 spec, llms.txt, per-user rate limits with Retry-After, and scoped admin tokens with approvals. Access starts at $499 a month with billing details at sign-up, the data API key has no scopes, and API key requests failed for 2 hours 38 minutes on 7 August 2026.

Before you call either

1upHealth

  1. Hand the Patient Access sign-in to the member, who must authorise in the health plan's auth app
  2. Exchange the authorisation code within five minutes, and refresh before the 15-minute token expires
  3. Email payer-patient-access@1up.health with the client ID to get the app synced to the demo environment
  4. Expect only claims and coverage resources from some payers, and read /r4/metadata first

Terra API

  1. Send dev-id and x-api-key headers on every Unified API and Terra AI call. A missing header returns 401 problem+json
  2. Keep each request window to 1,825 days or less and under 6,000 requested days per user an hour. On 429 with rule r2, wait Retry-After seconds
  3. Pass either fields or select to Terra AI tools, never both and never neither, or the call fails with a validation error
  4. Expect data by webhook after a user connects through the widget session. REST reads are for backfills and on-demand queries
  5. Use the Read only access level for the admin MCP server unless a change is needed. The MCP level can read API keys

Questions

Which is better for AI agents, 1upHealth or Terra API?

Terra API scores 65.9 (B) on agent readiness against 1upHealth's 46.8 (D), and leads in 5 of 7 scored categories. 1upHealth leads on transparency & trust.

Do 1upHealth and Terra API need an API key?

1upHealth uses an OAuth sign-in. Terra API takes an API key or an OAuth sign-in.

Can an agent call 1upHealth and Terra API without installing anything?

No hosted endpoint is listed for 1upHealth. Terra API has a hosted endpoint at https://access.tryterra.co/api/v2/mcp/<user_id>.

Other comparisons with 1upHealth or Terra API

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