Nikki's came with a small carrying case you can put into your pocket if I need to take them out away from home. I assume if they're self adjusting then they would 'adjust' any noise level. It's just hard since Nikki doesn't always tell us how she feels about things. I pretty much have to watch her face for hints sometimes. She has an appointment next week with her audiologist. I'll ask her what she thinks about the noise level too and the self adjusting part. Who do you insure hearing aids with? To tell you the truth, I'm not sure if these are insured or not. They're financed. Medicaid wouldn't pay anything on them so they're out of pocket for us too. Thanks!