One of the characteristics/symptoms of PMS is delayed or unreliable toileting.  While we are definitely in the delayed category at this point, I am hopeful someday to be in the reliable category.  Until then, however, pull-ups are expensive.  I contacted our lovely (private) insurance only to be denied.  Apparently our (self-funded) ppo plan does not provide for incontinence care.  I then turned to my beloved caseworker at the Regional Center.  She had to 'staff the request'.  She seemed reasonably sure that the RC will either reimburse us or provide pull-ups for him until he turns five.  If he still needs them then, MediCal will provide them.