Pay for 5G but don't get it

save your battery and set it to auto.

5G Auto, as @GLIMMERMAN76  mentioned is the best setting to use. I would set it to LTE just to make sure that you can get that without any issues. If you can, then try 5G Auto.

The Apple procedure for manually downloading the Carrier Settings usually works, but not always.

Why is LTE a settings option but not 4G?

@jmb2377 LTE is 4G. The 4G that used to display on an iphone was actually the 3G network which has been shut down. That is why 4G is no longer an option in settings.

what is the current recommendation for people on AT&T plans where 5G is insufficient

Recommendation for what exactly? ATT’s LTE network is still the predominant network. If 5G is spotty in your area, LTE should be fine. I don’t even have a 5G phone yet, LTE Is all I get and my coverage in the St Louis metro area and everywhere I have traveledhas been fine.

FWIW, I have a 5G capable phone and a 5G plan. 5G is not very reliable yet in our area so we just leave our phones on LTE only and it's fine. In-home, coverage is not very good so we just use WiFi-C (WiFi Calling) and calls in and out are perfect. Leaving WiFi-C enabled is not a problem when we are out and about because the phones just switch to LTE. When we go over to a friend's house, who has poor in-home AT&T reception, our phones just switch to WiFi-C (they gave us their pw) and we are good to go.

@jmb2377 I really find that hard to believe. Granted I haven’t been downtown Milwaukee in awhile but I was in Waukesha a month ago and drove through southern Milwaukee county on my way to Chicago and had great LTE coverage. Perhaps you are just in a dead zone which could mean your specific location may never see improvement.

So what's the difference between 4G and LTE, and is 4G or LTE better? In short,4G offers a much faster speed, more stability and access to a larger variety of online activities. LTE is a half-point between 3G and 4G, so its performance suffers compared to the fourth generation."

I don't know who wrote that quote, but it seems faulty...

LTE is not a midpoint between 3g and 4g. 

As an IT person you know that the G just stands for 'generation.' 

On at&t the order of generations is 2g, 3g, 4G, (sometimes as 4g/lte) LTE and now 5g. 

AT&T likes to do some Creative Marketing so some of 'generations had half generations. 

An AT&T's case 4G is really just better 3G. And 5ge was just better LTE. 

other people in my house are on a non-work plan (different carrier) and no issues.

Your with the wrong service provider.

It is always 100% on the customer to choose the service provider that provides the best coverage for their area. Clearly AT&T is not the provider for you.

While not helpful at all - yes, that's likely the correct answer.

If that's the correct answer, it's very helpful.

At some point you're going to have to accept that you've run out of different options rather than insisting there's some secret option that no one seems to know, yet you're sure exists.