I spoke to my local bank in Connecticut, People's United Bank, and they do HSA accounts. I am thinking of opening one up there. My IRA is with Vanguard. People's told me I would get a debit card to use once money is put in the HSA. I would then get credit card like statements which would be generated for all medical payments, on a monthly basis I presume. I don't know if there is any advantage in using Vanguard over People's which is where all my personal checking and savings accounts are.