If self-insuring, need at least 1 million baht (using government hospitals only) put aside and immediately available. 3 million if you want the option of private care. Most important - need a way to replenish as used. This is where many run into a problem. Over the years, many on this board have had to return to their home countries because their self insurance funds were depleted. Others failed to do that and wound up in really bad situation here, unable to pay for needed care. The other common mistake is to just put aside the premium amounts without an initial lump sum to start with. This assumes there will be no big expenses for many years until these sums have accrued. Absolutely no reason to assume that at any age and certainly not past 65, very risky. You need to start with 1-3 million baht set aside. Certainly someone who can put these sums aside now, and then replenish them as used, can self insure. But in my experience most who have this amount of money prefer to insure so as to protect their assets, assuming they are insurable (some people have no choice due to existing health conditions.)