# 1upHealth vs Zus Health

> Zus Health scores 56.6 (C) to 1upHealth's 46.8 (D) for patient record retrieval. Prices, MCP, x402, uptime and agent notes side by side.

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- 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
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- Updated: 2026-10-15

Zus Health scores 56.6 (C) on agent readiness against 1upHealth's 46.8 (D), and leads in 4 of 7 scored categories. 1upHealth leads on security & auth, payments & pricing and transparency & trust. Both do patient record retrieval.

- 1upHealth: grade D, 46.8/100, rank #917 of 1094. Markdown https://www.anchorterminal.com/tools/1uphealth.md · JSON https://www.anchorterminal.com/api/v1/tools/1uphealth.json
- Zus Health: grade C, 56.6/100, rank #674 of 1094. Markdown https://www.anchorterminal.com/tools/zus-health.md · JSON https://www.anchorterminal.com/api/v1/tools/zus-health.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:
- Security & auth, 63 against 49
- Payments & pricing, 20 against 5
- Transparency & trust, 72 against 59

Watch for: No rate limits, 429 handling or error formats documented

### Zus Health (C)

Good for: US care organisations and digital health builders that want a shared, continuously refreshed patient profile in FHIR with EHR embedding.

Ahead on:
- Reliability, 66 against 52
- Schema & documentation, 77 against 50
- Agent ergonomics, 67 against 32
- Maintenance & community, 64 against 37

Watch for: No public prices, and the sandbox is requested through a Google Form


## Score by category

| Category | Weight | 1upHealth | Zus Health | Edge |
| --- | --- | --- | --- | --- |
| Reliability | 16% (20 this run) | 52 | 66 | Zus Health +14 |
| Performance | 10%, pending | pending | pending | not scored in this run |
| Schema & documentation | 13% (16.2 this run) | 50 | 77 | Zus Health +27 |
| Agent ergonomics | 13% (16.2 this run) | 32 | 67 | Zus Health +35 |
| Security & auth | 14% (17.5 this run) | 63 | 49 | 1upHealth +14 |
| Payments & pricing | 10% (12.5 this run) | 20 | 5 | 1upHealth +15 |
| Task success | 10%, pending | pending | pending | not scored in this run |
| Maintenance & community | 7% (8.8 this run) | 37 | 64 | Zus Health +27 |
| Transparency & trust | 7% (8.8 this run) | 72 | 59 | 1upHealth +13 |
| Negative events | ≤15 | 0 | 0 | |
| **Total** | | **46.8 · D** | **56.6 · C** | |

## Facts side by side

| Fact | 1upHealth | Zus Health |
| --- | --- | --- |
| Kind | HTTP API | HTTP API |
| Vendor | 1upHealth, Inc. | Zus Health, Inc. |
| Hosted endpoint | no (local only) | no (local only) |
| Transports | HTTP | HTTP |
| Auth | OAuth | OAuth |
| Pricing | Paid | Paid |
| x402 | no | no |
| Licence | Proprietary service under 1upHealth's Terms of Service (effective 1 August 2024) | Proprietary service under the Zus Builder Terms of Service (last updated 11 March 2025), the Developer Sandbox Terms and the Zus Business Associate Addendum |
| Read-only variant documented | no | no |
| llms.txt | yes | yes |
| Last release | none | 2026-10-14 |
| Terms last updated | no date given | 2025-03-11 |
| Privacy policy last updated | 2026-06-25 | 2026-06-24 |
| 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 | not found in the text |
| Terms or service can change without notice | not found in the text | not found in the text |
| Arbitration or class-action waiver | not found in the text | not found in the text |

## 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.

**Zus Health.** FHIR R4 over an aggregated patient profile drawn from CommonWell, Carequality, Surescripts, Quest and ADT networks, with published rate limits, a 99.5 per cent SLA and a dated changelog. Accounts and sandboxes are provisioned by Zus on request, with no public prices, no named security certification and no SDK.

## 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

### Zus Health

1. Cache the access token for its hour. More than 200 token requests an hour per App Client returns 429
2. Request Patient History at most once per patient per 24 hours, and poll the job status endpoint
3. Use conditional create by identifier so a retried write doesn't duplicate a resource
4. Send `Zus-If-Match` with the resource's ETag on PUT and PATCH
5. Set `_count` up to 500 on searches, since the default page is 10

## Questions

### Which is better for AI agents, 1upHealth or Zus Health?

Zus Health scores 56.6 (C) on agent readiness against 1upHealth's 46.8 (D), and leads in 4 of 7 scored categories. 1upHealth leads on security & auth, payments & pricing and transparency & trust.

### Do 1upHealth and Zus Health need an API key?

Both use an OAuth sign-in.

### Can an agent call 1upHealth and Zus Health without installing anything?

No hosted endpoint is listed for 1upHealth. No hosted endpoint is listed for Zus Health.


## For agents

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

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