Yes, as long as you have a HDHP you can have one. My employer doesn't contribute to it or offer one, so I had to do it myself. This means that it's not a payroll deduction (so I don't save the FICA and medicare taxes) but I take the deduction when I file my taxes. Wells Fargo was great because as long as you have $5000 in it there was no monthly fee and I bank with them anyway. I initially set it up to pay for the kids' braces, but the more I've learned about it the more I realized I need to max it out every year (as long as I'm maxing out the employer match on my 401k) because it's tax advantaged (more so than a 401k). It's the only reason I have a HDHP. We have another plan with a very similar premium and better coverage/lower deductible but I'm not giving up my ability to contribute to an HSA.