# 1upHealth vs Terra API

> Terra scores 65.9 (B) to 1upHealth's 46.8 (D) for fhir servers. Prices, MCP, x402, uptime and agent notes side by side.

- Canonical: https://www.anchorterminal.com/compare/1uphealth-vs-terra
- Markdown: https://www.anchorterminal.com/compare/1uphealth-vs-terra.md (~2,300 tokens)
- Slim: https://www.anchorterminal.com/compare/1uphealth-vs-terra.min.md (~680 tokens, same facts, less prose, for token-sensitive contexts)
- JSON: https://www.anchorterminal.com/compare/1uphealth-vs-terra.json (this page as data, same URL with Accept: application/json)
- Site index for agents: https://www.anchorterminal.com/llms.txt (full text: https://www.anchorterminal.com/llms-full.txt)
- API: https://www.anchorterminal.com/api/v1/index.json
- Updated: 2026-10-14

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.

- 1upHealth: grade D, 46.8/100, rank #903 of 1076. Markdown https://www.anchorterminal.com/tools/1uphealth.md · JSON https://www.anchorterminal.com/api/v1/tools/1uphealth.json
- Terra API: grade B, 65.9/100, rank #327 of 1076. Markdown https://www.anchorterminal.com/tools/terra.md · JSON https://www.anchorterminal.com/api/v1/tools/terra.json
- Best health record and wellness data APIs for AI agents: https://www.anchorterminal.com/best/health-data/index.md
- All 63 health comparisons: https://www.anchorterminal.com/compare/health-data/index.md

## Which one, for what

### 1upHealth (D)

Good 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)

Good 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

| Category | Weight | 1upHealth | Terra API | Edge |
| --- | --- | --- | --- | --- |
| Reliability | 16% (20 this run) | 52 | 67 | Terra API +15 |
| Performance | 10%, pending | pending | pending | not scored in this run |
| Schema & documentation | 13% (16.2 this run) | 50 | 89 | Terra API +39 |
| Agent ergonomics | 13% (16.2 this run) | 32 | 78 | Terra API +46 |
| Security & auth | 14% (17.5 this run) | 63 | 65 | Terra API +2 |
| Payments & pricing | 10% (12.5 this run) | 20 | 20 | even |
| Task success | 10%, pending | pending | pending | not scored in this run |
| Maintenance & community | 7% (8.8 this run) | 37 | 75 | Terra API +38 |
| Transparency & trust | 7% (8.8 this run) | 72 | 56 | 1upHealth +16 |
| Negative events | ≤15 | 0 | 0 | |
| **Total** | | **46.8 · D** | **65.9 · B** | |

## Facts side by side

| Fact | 1upHealth | Terra API |
| --- | --- | --- |
| Kind | HTTP API | HTTP API |
| Vendor | 1upHealth, Inc. | Terra Enabling Developers Inc. |
| Hosted endpoint | no (local only) | `https://access.tryterra.co/api/v2/mcp/<user_id>` |
| Transports | HTTP | HTTP, Streamable HTTP |
| Auth | OAuth | OAuth or key |
| Pricing | Paid | Pay per use |
| x402 | no | no |
| Licence | Proprietary 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 exposed | none | 6 |
| Read-only variant documented | no | no |
| llms.txt | yes | yes |
| Last release | none | 2026-10-13 |
| Terms last updated | no date given | 2026-05-01 |
| Privacy policy last updated | 2026-06-25 | 2023-04-20 |
| Customer content may train models | not found in the text | not found in the text |
| Terms restrict automated access | not found in the text | not found in the text |
| Terms restrict benchmarking | yes | yes |
| Terms or service can change without notice | not found in the text | yes |
| Arbitration or class-action waiver | not found in the text | yes |
| Popularity | none | 13k 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>.


## For agents

- This comparison as JSON: https://www.anchorterminal.com/compare/1uphealth-vs-terra.json, and with the fewest tokens: https://www.anchorterminal.com/compare/1uphealth-vs-terra.min.md
- Over MCP at https://www.anchorterminal.com/mcp (no key): `compare_tools {"a": "1uphealth", "b": "terra"}`. From a terminal: `anchor compare 1uphealth terra`
- Each listing in full: https://www.anchorterminal.com/api/v1/tools/1uphealth.json and https://www.anchorterminal.com/api/v1/tools/terra.json

## Other comparisons with 1upHealth or Terra API

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- [1upHealth vs Redox](https://www.anchorterminal.com/compare/1uphealth-vs-redox.md)
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