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If referring to the mandatory health insurance for an OA visa or extension of ( retirement only) then:

For retirement extension: the coverage will increase from 40/400k baht to 3 million baht in September 2022 .

For new OA visa: best to contact your home country Thai Embassy for actual requirements, it was required that a new OA visa requires the 3 million baht coverage from 1st October 2021 but the website may not have been updated 

In answer to your initial question:

It is coverage and the cheapest cover will probably cost you around 30/50k baht with deductibles and depending on your age.

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The Health Insurance requirement only applies to the Non Imm O-A Visa, and subsequent extension of stay applications at Immigration when you entered on that Visa type.

For retirement purposes, apply for the Non Imm O Visa, which requires the Health Insurance cover for only 90 days (the permission granted on entry). It is not required for subsequent 1-year extension of stay at Immigration thereafter.

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