In the face of the problem posed by the financial deficit of the Sickness and Maternity Insurance in terms of its coverage for affiliates and pensioners, we had to look for methodologies to assess the future trends of revenues and expenses.

To estimate the coverage expense for Medical Expenses for Pensioners (gastos médicos de pensionados (GMP)), in 2013 we developed an actuarial model with which we could estimate the sufficient leveled premium to settle the future expenses based on the results obtained.

The strategic lines followed are listed below:

• To estimate the medical expenses profiles for the population eligible for the coverage of GMP, based on the information available in the Mexican Social Security Institute.
   
• To develop our own actuarial model of the IMSS in order to assess the financial situation of the coverage of GMP.

The items that allow us to perform a better assessment of the medical expenses are:

• The identification of medical expenses profiles according to the morbidity of the population to valuate.
   
• The separate estimation of the population susceptible to the use of medical services, formed by direct pensioners, beneficiaries of the pensioners and beneficiaries of the deceased workers.