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Assisted Living Maryland

Maryland offers access to the Chesapeake Bay, Potomac River and Atlantic Ocean, making it a great choice for seniors who want to be close to the water. But the state isn’t all sailing opportunities and crab dinners; there are many more practical reasons to choose a Maryland retirement. Almost 16% of the state’s 1.6 million residents are aged 65 and older, and the senior population has access to nationally ranked hospitals such as Johns Hopkins, which has a specialized geriatrics team. This is one reason why the state ranked ninth for health care in the 2024 Senior Living Report.

For affordability, Maryland ranks 13th. Although the cost of living here is higher than average, the cost of health care is low. Additionally, Social Security benefits are exempt from state income tax and there’s a generous deduction for taxpayers aged 65 and older. Tax dollars go toward programs that help seniors, such as discounted public transportation, and the cost of assisted living in the state averages $4,900 per month.

This guide offers insight into the costs of assisted living and other forms of senior care in Maryland. It also has information about resources available to help seniors, and the rules and regulations that govern assisted living in the state.

The Cost of Assisted Living in Maryland

When trying to decide how to pay for assisted living, one of the first questions that comes up is "How much does it cost?" With the impact of inflation, it's more important than ever to have up-to-date information when making a financial plan for senior living. To help shed light on real senior living prices, Caring.com has compiled proprietary cost data from its network of over 75,000 senior living providers to offer insight into the average cost of assisted living in Maryland and its 35 cities.

The Cost of Assisted Living in Maryland's Top Cities

Several cities in Maryland compare well with the state’s average of $5,091, such as Gaithersburg ($5,030) and Rockville ($5,030). Conversely, others fall below the average, such Frederick at a low of $3,908 (or $1,183 less). Baltimore, however, is considerably more expensive at $5,631 per month. Even though lower care costs are appealing, it is crucial to determine the services and benefits at given prices for effective planning.

Maryland

$5,091

Baltimore

$5,631

Frederick

$3,908

Gaithersburg

$5,030

Rockville

$5,030

Inflation's Impact on the Cost of Assisted Living in Maryland

To answer the question of how inflation affects senior living in Maryland, average costs rose from $4,613 to $5,091 in 2022–2023. Maryland’s dollar change represents a 10.36% rise, a little above the national average of 9.55%, where costs rose from $4,070 to $4,459.

Inflation in Pennsylvania prompted an increase of 19.06% to $4,653, but the most significant increase was in West Virginia at 23.22%. In contrast, Delaware ($4,587) and Virginia ($4,604) had lower inflation rates of -12.86% and -0.79%. Using this and other data, seniors can plan their futures with greater care.

Location2022 Cost (Historical)2023 Cost (Current)2024 Cost (Estimated)
Maryland$4,613$5,091$5,153
U.S. Average$4,070$4,459 $4,802
Pennsylvania$3,908$4,653$5,016
Delaware$5,264$4,587$4,885
Virginia$4,641$4,604$5,013
West Virginia$4,198$5,173$5,183

The Costs of Other Types of Senior Living

Maryland care costs cover a spectrum, with assisted living averaging $5,091. In contrast, memory care is higher at $5,489. Memory care is typically more costly than other forms since it comes with additional medical and other support benefits.

Besides these choices, independent living is usually at the bottom of the scale, as seniors who choose this option require less specialized care. In Maryland, independent living averages $3,484. With this range of alternatives, seniors can choose their care according to their unique needs.

Assisted Living

$5,091

Memory Care

$5,489

Independent Living

$3,484

Does Medicaid Cover Assisted Living in Maryland?

Maryland Medicaid, also known as Medical Assistance (MA), doesn’t directly fund assisted living. Instead, the state offers waiver programs that help older adults who wish to remain living at home or in the community.

Two of these waivers can be used to provide services in assisted living facilities: the Community Options (CO) Waiver and the Increased Community Services (ICS) Waiver. They’re available to people who meet certain functional and financial eligibility criteria and services that are provided include case management, nutritionist services and behavioral consultation.

What Assisted Living Services Are Covered by Medicaid in Maryland?

The CO and ICS waiver programs provide similar services and supports, but the ICS program is specifically designed to help people living in nursing homes transition back to the community. 

Covered services include personal care, assistive technology, supports planning and nutritionist services. Assisted living is listed as a separate benefit for both waiver programs and covers the care you receive in these residential facilities, such as meals, activity programs and case management. Although not specifically stated, Medicaid waiver programs typically don’t pay for room and board.

Assisted Living Waiver Programs in Maryland

Community Options Waiver

The Community Options Waiver is also known as the Home and Community-Based Options Waiver. It’s designed to help people who need a nursing home level of care remain living in the community. In addition to delaying or preventing an individual’s entry into a nursing home, this waiver is also available to people who currently reside in a nursing home and want to return to their home or an assisted living community. 

The waiver is available to people aged 18 and over who meet the level of care required for placement in a nursing home. Applicants must also meet the financial eligibility requirements for waiver programs in the state. 

The services offered through the program include assisted living, case management, dietitian and nutritionist services and behavioral consultations. Recipients are also eligible to receive Medicaid services, which can include personal care, nurse monitoring and transition services. Not all assisted living facilities participate in the program, and those that do must be willing to accept Medicaid payment rates. 

People currently living in a nursing home can apply by contacting Maryland Access Point at (844) 627-5465. The program isn’t currently accepting applications from people living in the community, but you can contact the above number to be put on the waiting list. 

Increased Community Services Program

The Increased Community Services Program is specifically designed to help people living in nursing homes move back into the community. This could mean returning to their home, or moving into the home of a relative or an assisted living facility. The program provides transitional services to support recipients as they move, as well as long-term care services to support them in the community.

To be eligible for the program, applicants must currently reside in a nursing home and have been living there for at least 3 months. In addition, they need to have been Medicaid eligible for at least 30 days of those three months. Applicants must also require a nursing home level of care and meet the financial eligibility criteria for Maryland Medicaid’s waiver programs. An individual’s application won’t be approved if the cost of their care in the community will exceed what Medicaid pays for the nursing home care they’re currently receiving. 

Services provided through the program include personal assistance, care planning, nurse monitoring and assistive technology. Assisted living is listed as a benefit of the program and includes the services generally provided in these facilities, such as meals and social programming. 

Seniors can apply for the program by contacting Maryland Access Point at (844) 627-5465. 

How To Know If You’re Eligible for Medicaid in Maryland

As Medicaid is designed to help low-income people access health care, your financial situation is the primary criteria for eligibility. You must meet income and asset limits that differ depending on your circumstances and the Medicaid program you’re applying for. 

To be eligible for Maryland’s waiver programs, applicants must have an income of less than $2,742 per month or $32,904 per year. Married couples who are both applying are allowed to earn $65,808 a year. The asset limit is $2,000 for individuals and $3,000 for married couples when both spouses are applying. 

If only one spouse is applying, the asset limit is $2,000 for the applicant. However, the non-applicant spouse can keep up to $148,620 in assets. To meet Medicaid’s spousal impoverishment provisions, Maryland also lets the applicant transfer some of their income to their spouse as a minimum monthly maintenance needs allowance. 

Medicaid doesn’t count all assets when calculating your eligibility. Personal belongings, an automobile and irrevocable burial trusts are exempt. A home is also exempt if your spouse still lives there. Maryland has alternative pathways to qualify for Medicaid for people who don’t meet the financial limits. This includes spending down assets and income. 

 

2022 Medicaid Income Limits for Seniors in Maryland

Household SizeNumber of ApplicantsIncome Limits Per Year*Asset Limits: Applicant(s)Asset Limits: Non-Applicants
One Person1$32,904$2,000
Two People1$32,904**$2,000148,620
Two People 2$65,808***$3,000

*Depending on the facility setting, a recipient may not be able to keep income up to this level.

**Income limit is for applicant only.

***Income is limited to $2,742 per month per spouse.

 

There are other criteria that applicants must meet to be eligible for Medicaid. Those applying for the waivers must be:

  • A Maryland resident
  • A U.S. citizen or non-citizen who meets the immigration status requirements
  • In need of a nursing home level of care 

 

How To Apply for Medicaid in Maryland

People in need of Medical Assistance long-term services and supports, such as waiver programs, can apply online through the myMDThink portal. You can also submit a paper application in person or by mail. People living in Baltimore City or Anne Arundel, Baltimore or Prince George’s counties can return applications to the Bureau of Long Term Care. Applications from other areas of the state can be returned to a local Department of Social Services office. Application forms are available for download on the Medicaid website.

Information You Will Need 

The Maryland Department of Health requires documentation to process your application. You may be asked to provide:

 

  • Proof of identity
  • Proof of citizenship or immigration status
  • Proof of residency
  • Income statements, including banks statements and federal tax returns
  • Proof of assets, including current statements of stocks, life insurance policies and trusts
  • Private health insurance cards, including Medicare
  • Social Security number
  • Power of attorney or legal guardianship documents 

 

How to Get Help Applying for Medicaid

Maryland has resources available for people who need help applying for Medicaid. Counselors available through the State Health Insurance Program can provide face-to-face guidance at offices throughout the state. In addition, Maryland provides detailed information on its Medicaid website and through the Long Term Care guidebook.

ProgramContactServices provided
State Health Insurance ProgramContact local officeThe State Health Insurance Program has volunteer counselors in all 23 counties of Maryland and Baltimore City who can help people navigate their health insurance options. The service is designed to assist with Medicare, but counselors can also give advice about assistance for low-income benefit programs, such as Medicaid.
Medicaid WebsiteOnlineThe Medicaid website in Maryland has detailed information about available programs, eligibility criteria and how to apply. Applicants can explore the programs that offer long-term services and supports and discover the ones they may be eligible for.
Home and Community-Based Long Term Care Services GuidebookOnlineThe Home and Community-Based Long Term Care Services Guidebook has information about the waiver programs available in the state, including those aimed at older adults. It details the benefits available, eligibility criteria and who to contact for further information.

Does Medicare Cover Assisted Living in Maryland?

The short answer is that no, Medicare does not cover the cost of assisted living in Maryland. Assisted living facilities are considered to be a “residential setting” and not a “clinical setting,” (think nursing homes). While Medicare doesn’t cover the cost of care received in an assisted living community, it does still cover things like approved medications, doctor visits, medical equipment, etc., just like it would if you lived at home.

For more information about when Medicare can be used to pay for senior living in a nursing home, and for Medicare-related resources, see our guide to Nursing Homes in Maryland.

Paying for Assisted Living Facilities in Maryland

The HCBS waiver program in Maryland provides a number of home and community-based services. Using the Medicaid 1915(c) HCBS Waiver, Maryland covers Level 2 and Level 3 ALP services for Medicaid beneficiaries.

To be eligible, applicants must:

  • Be 65 years of age or older
  • Be a resident of Maryland
  • Have no more than $2,024 in monthly income
  • Own no more than $2,500 in personal assets
  • Be a U.S. citizen or meet immigration status requirements
  • Have a valid social security number
  • Meet medical eligibility requirements

Eligibility requirements can be found at the myDHR website. They can also be requested by mailing a completed application or visiting your local social services office.

Other Financial Assistance Options for Assisted Living in Maryland

Seniors who are not eligible (due to location, financial situation, or other factors) for other types of financial assistance, do still have some options. See the table below for an overview of some of the most common ways to make Assisted Living affordable.

NameHowToApplyHowItWorks
Aid and AttendanceLearn more and apply online at va.gov.Veterans who receive a VA pension may also be eligible for the Aid and Attendance benefit, a monthly cash allowance that veterans receive in addition to their standard pension amount. The benefit is intended for veterans in need of long-term care services and may be used towards paying for Assisted Living.
Reverse MortgagesLearn more about your options and how to apply at ftc.govIf you own a home, you may be able to use a reverse mortgage to help pay for Assisted Living. Reverse mortgages are loans that one can take out against the value of their home, essentially converting some of the home's equity into cash. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan.
Long-Term Care (LTC) InsuranceLearn more about Long-Term Care Insurance and how to apply for a policy at acl.gov.Seniors who already have long-term care insurance may be able to use it to pay for Assisted Living. Most policies cover at least a portion of the cost, but it depends on the specific policy terms. Note that older adults who are already in need of Assisted Living will not typically be eligible to sign up for a LTC insurance policy.

Free and Low-Cost Resources for Seniors in Maryland

There are many resources in Maryland that assist seniors in their retirement. Caring.com has compiled information on local organizations, programs and agencies and categorized them into care types for easy reference.

Area Agency on Aging

Retirees can find support and advice on various senior-related issues from their local Area Agency on Aging. The agency provides advice on topics such as financial assistance programs, in-home care and long-term care planning. It also connects seniors and caregivers with community-based resources.

Program NamePhone NumberDescription
Maryland Area Agencies on AgingMaryland's Area Agencies on Aging are nonprofit organizations that support the needs of older adults, their families and caregivers across the state. They offer a range of services and programs that promote independent living and help enhance seniors' quality of life. AAAs provide personalized care planning, home-based services, transportation assistance and meal programs. They also offer information and referral services, benefits counseling and caregiver support. Through Maryland's AAAs, seniors can access the resources they need to age with dignity.

Cash Assistance Programs

Cash assistance programs in Maryland provide financial support to help low-income retirees remain in their own homes for as long as possible. Seniors and caregivers can apply for tax rebates and reductions, discounts on vital services and help covering the cost of heating and cooling their home.

Program NamePhone NumberDescription
Maryland Lifeline Program800-234-9473The LifeLine Program offers a discount on landline or mobile telephone service, ensuring that participants can stay in contact with loved ones.

Financial Assistance for Senior Care and Senior Living

Whether living in their own home or in a senior living community, Maryland seniors can find financial assistance from numerous local resources. These organizations help residents cover some of the costs associated with in-home or long-term care and connect them with other helpful community-based resources.

Program NamePhone NumberDescription
Maryland Access Point (MAP)844-627-5465Maryland Access Point locations can help you find assistance programs available in your community.

Food Assistance Programs

Local organizations help ensure elderly citizens have a balanced diet and receive essential vitamins and minerals to remain healthy. Through nutrition programs, congregate meals, home-delivered meals and food pantries, these programs help Maryland seniors afford the nutritious food they need.

Program NamePhone NumberDescription
Maryland 211 Food PantriesLow-income seniors in Maryland who are able to leave their homes have many options for free and affordable food. Food pantries and banks throughout the state provide free produce, grains and other staples, and many have no eligibility requirements
Maryland Meals on WheelsMaryland Meals on Wheels offers nutritious home-delivered and congregate meals for qualifying seniors ages 60 and over. Eligibility is open to those who cannot easily shop for groceries and prepare meals due to limited mobility. With home-delivered meals, seniors receive friendly daily visits that provide valuable social interaction and safety checks for those at risk of falls or accidents. Congregate meals are served at local senior centers and are available on a sliding fee scale.
Maryland Supplemental Nutrition Assistance Program (SNAP)800-332-6347SNAP gives you a card that can be used at grocery stores, convenience stores, online food delivery services and even some restaurants.

Financial Assistance for Senior Living

Low-income elderly individuals in senior living communities can access financial assistance through local-run programs. These Maryland resources offer advice, guidance and support to help older adults pay for the services offered by long-term care providers.

Program NamePhone NumberDescription
Maryland Senior Assisted Living Subsidy Program410-767-1100Seniors facing Nursing Home placement may receive a direct financial subsidy to help pay for Memory Care as an alternative. Subsidies cover a maximum of $1,000 per month, and financial eligibility limits apply. This program is designed for moderate-income seniors who may not qualify for traditional Medicaid programs and for those aged 62 and older.

Free Used Medical Equipment

Due to the high cost of purchasing new medical equipment, several organizations in Maryland collect lightly used medical devices such as wheelchairs, ramps and walkers and distribute them to local seniors and residents in need.

Program NamePhone NumberDescription
Maryland Assistive Technology Reuse Center (MATR)443-326-9703The Maryland Assistive Technology Reuse (MATR) Center provides high-tech assistive equipment to individuals who have some form of disability. Funded entirely by donations, MATR provides pre-used assistive technologies at no cost. The only requirement is that equipment be re-donated to the center once it's no longer needed. MATR maintains an online inventory of all available equipment. Devices include assisted vision equipment, assisted listening devices and augmentative and alternative communication devices for individuals with speech impediments.
Maryland Bay Area Center for Independent Living - Free Loan Closet443-260-0822The Bay Area Center for Independent Living, Inc., a nonprofit agency in Salisbury, MD, connects adults with disabilities and their families to various services and programs across nine counties. The center works closely with the Maryland Technology and Assistance Program to provide temporary ramps to people who need wheelchair access to their homes. Workshops and resources are also available at the center to help disabled individuals navigate the complex social security system.
Maryland Durable Medical Equipment Re-Use Program240-230-8000The Durable Medical Equipment Re-Use program collects donations of equipment from sites throughout Maryland and distributes them to seniors in need. Sites offer basic DME, such as canes and bedrails, and complex DME, such as power wheelchairs, home hospital beds and mechanical lifts.

Home Repair and Modifications

Seniors and those with disabilities can access a variety of local resources to help them pay for home repairs and modifications. Programs in Maryland have different eligibility criteria and often assist retirees by providing grants or loans.

Program NamePhone NumberDescription
Maryland Accessible Homes for Seniors844-369-4150This program provides zero-interest loans and grants to seniors for modifications to their homes. The funds are available for improvements that make the property accessible and functional, such as widening of doorways, installation of ramps and modifying bathrooms with grab bars. The maximum loan amount is 110% of the value of the property.

Many organizations offer free or low-cost legal services to Maryland seniors. Older adults can access advice on issues such as estate planning, living wills and power of attorney. Some firms also act as long-term care ombudsmen, advocating for the rights of seniors in senior living communities.

Program NamePhone NumberDescription
Maryland Legal Aid866-635-2948Maryland Legal Aid's Senior Legal Helpline offers counseling and advice to the elderly. It helps low-income individuals locate pro bono representation in civil matters (although not in criminal cases). Other services include preparing legal documents and helping seniors file for divorce or bankruptcy.
Maryland Long-Term Care Ombudsman Program (LTCOP)301-265-8483The Maryland Long-Term Care Ombudsman Program is dedicated to upholding the welfare of long-term care residents throughout the state. The program's volunteers and paid staff work together to provide services such as informing individuals of their rights, resolving concerns and complaints and making suggestions to improve care quality in facilities. All services provided by LTCOP are free and confidential. Residents and concerned parties can access the state's ombudsman by county.

Medicaid Resources

Navigating the Medicaid system is often difficult and confusing. Several Maryland resources help older adults by providing advice on Medicaid options, waiver programs and eligibility criteria to help seniors receive the right health care benefits.

Program NamePhone NumberDescription
Maryland's Community First Choice Program877-463-3464This program enables seniors to remain in their own homes by providing a variety of services, including personal assistance, home-delivered meals, accessibility adaptations, assistive technology and support planning. It also covers nurse monitoring and other home health services.

Social Security Offices

Social Security offices in Maryland help seniors and disabled people access the benefits they're entitled to. Older adults can contact their local office for information about receiving retirement benefits, disability allowance and Supplemental Security Income.

Program NamePhone NumberDescription
Maryland Social SecuritySocial Security is a source of income available to retirees and people who can no longer work because of a disability. The money for Social Security comes from a payroll tax levied on employers, employees and self-employed individuals. When you retire, you'll receive monthly payments based on how much you earned when you were working.

Tax Assistance

Seniors can apply for tax assistance from several Maryland resources. Elderly residents and those with disabilities could be eligible for tax exemptions on medical expenses, reductions on property tax and other tax assistance programs.

Program NamePhone NumberDescription
Homeowners' Property Tax Credit Program410-767-5900This tax credit program limits the amount seniors pay on their property taxes based on their income. The credit is applied directly to the tax bills of homeowners, and it does not apply to the value of the property exceeding $300,000.

Utility & Energy Bill Assistance

Low-income seniors who are struggling to meet the costs of maintaining their homes can find support from organizations that offer assistance with utility and energy bills. Maryland retirees could also qualify for emergency funding programs if they're in danger of losing utility services due to unpaid invoices.

Program NamePhone NumberDescription
Maryland Low Income Household Water Assistance Program (LIHWAP)800-332-6347Seniors at risk of losing their access to water due to a lack of funds may be eligible for assistance through LIHWAP. The program gives eligible households up to $2,000 to pay for water and wastewater bills. You can apply for LIHWAP online or over the phone.
Maryland Office of Home Energy800-332-6347The Maryland Office of Home Energy offers a financial assistance program for low-income families who are unable to afford their electricity or heating bills. The program pays your utility bills directly if you're short on funds, and you don't need a turn-off notice to qualify.

Veteran's Services

Maryland retirees who have served in the U.S. military can find support from local veteran services. These offices and organizations help vets access the benefits they're eligible for and provide advice and information on a variety of issues.

Program NamePhone NumberDescription
Maryland VA Benefits and Health CareMaryland's VA Benefits and Health Care provides assistance to eligible senior veterans through medical centers located in Baltimore, Perry Point and at other facilities across the state. The program offers older vets access to service-connected disability support as well as physical therapy, hearing and vision care, cancer treatment and pain management. Veterans can receive help navigating VA benefits, compensation and social services, including guidance with senior housing options and financial planning.

Assisted Living Laws and Regulations in Maryland

In Maryland, assisted living facilities are licensed and overseen by the Office of Health Care Quality, a division of the Department of Health. This office ensures that facilities comply with the laws and regulations that govern long-term care facilities in the state.

TopicRule
Assisted Living Service Plan Requirements A service plan must be developed within 30 days of admission, outlining what services will be provided and by whom. Assessments include evaluations of a resident's social and recreational needs, habits and cognitive abilities. They account for risk factors, problematic behaviors and the ability to self-administer medications. The service plan must be reviewed and updated at least every 6 months or if there’s been a significant change in the resident’s needs or preferences.
Assisted Living Admission Requirements On admittance, the facility must complete the Resident Assessment Tool to determine a resident’s care needs. This tool includes a complete functional assessment and is used to develop the individual's service plan. Residents won’t be admitted if they have Stage III or IV skin ulcers, need a ventilator or skilled monitoring, or are a danger to themselves or others.
Assisted Living Scope of Care An assisted living facility is a residential program that provides housing, supervision, personalized assistance, health-related services or a combination of these services to meet residents' needs. Facilities can be licensed to provide low (Level 1), medium (Level 2), or high (Level 3) levels of care. Level 1 facilities can cover coordination of health services, while Level 3 ALFs may offer psychiatric monitoring.
Assisted Living Medicaid Policy Maryland residents may be eligible for financial assistance and subsidies available through Maryland's Medicaid program by using the HCBS waiver program. Participating facilities must be properly licensed, choose to take part in these programs and be willing to accept Medicaid rates of payment. Level 2 and Level 3 ALPs are eligible providers under the Medicaid waiver program.
Assisted Living Facility Requirements Resident rooms must meet minimum size requirements; no more than two people can share a room. Each room needs adequate storage for residents’ personal belongings. Facilities must provide furnishings, including a bed, unless the resident brings their own. All toilets, showers and bathtubs need assistive railings unless a waiver is granted. There must be one toilet per four residents and one toilet for each floor, as well as one bathtub or shower for every eight residents.
Medication Management Regulations Residents with at least nine medications need their regimen reviewed by a pharmacist every 6 months. All staff who administer medications must complete a medication administration course. Drugs must be kept in a secure location, and staff are required to document when medication has been provided. If a resident is living in the same facility as their spouse or domestic partner, their spouse can administer medications for them.
Staffing Requirements There must be ample on-site staff to meet the needs of residents. When the manager is not available, there must be an alternate manager. Maryland doesn't require that staff must be awake overnight. Instead, the Resident Assessment Tool is used to determine if awake staff are needed. Or, the facility can obtain a waiver to use electronic monitoring. All residential homes and communities need a contracted or employed registered nurse to provide nursing services.
Staff Training Requirements Assisted living managers must complete state training and pass the relevant examination, in addition to meeting educational requirements based on the facility's licensing level. Managers with five or more residents must complete 20 hours of continuing education every two years. Other staff must participate in an orientation program and ongoing training. Annual training should cover topics including infection control and food safety.
Background Checks for Assisted Living All staff must undergo a criminal history records check or criminal background check within 30 days before they begin their employment. Facilities can’t hire anyone with a history of behavior that's potentially harmful to residents.
Requirements for Reporting Abuse Any abuse or suspected abuse must be reported within 24 hours to Adult Protective Services by calling (800) 917-7383. Alternatively, it can be reported to relevant agencies including the long-term care ombudsman, local law enforcement and the Office of Health Care Quality, which can be reached at (877) 402-8221.

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The material on this site is for informational purposes only and is not a substitute for legal, financial, professional, or medical advice or diagnosis or treatment. By using our website, you agree to the Terms of Use and Privacy Policy

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