Medicaid Exemption Form 2015

Lynden businesses and homes are assessed a monthly $6 Ambulance Utility fee. This money is used to support emergency medical services in Lynden. It is billed on your water utility bill or if you do not have City water on a separate bill just for the ambulance utility fee.

You may be exempt if you are Medicaid eligible and are receiving in home services paid for by Medicaid. Please complete the attached form and return it to the Fire Department @ 215 Fourth Street Lynden WA 98264 and include proof of Medicaid eligibility.