Having 24/7 access to one dedicated AWS employee (the technical account manager (TAM) you get as part of premium support) can be _really_ helpful. Such TAMs can

Having 24/7 access to one dedicated AWS employee (the technical account manager (TAM) you get as part of premium support) can be _really_ helpful. Such TAMs can get you direct access to the product teams inside of AWS in case you need it and can escalate problems quickly. Still, it really depends on what you're doing at which scale with AWS. I also found business support quite good, if you don't need such dedicated resources. Regarding seeing issues, it's simply a matter of probabilities: The more you run in AWS the more likely it is to get problems sooner or later with one or the other service. My advice is to start with business support and see based on the experiences with it if you have additional requirements business support doesn't meet. If yes, you might then better know if premium support might offer enough value for its money.