Is Equine Therapy Covered By Insurance?

Equine therapy is increasingly offered as part of comprehensive addiction and mental health treatment programs, but whether insurance covers it depends almost entirely on how it’s delivered. When equine therapy is part of an accredited residential or inpatient program where the overall treatment is covered, insurance typically covers it as part of that program.

As a standalone wellness service, it generally isn’t covered. Here’s what you need to know.

What Is Equine Therapy?

Equine-assisted therapy (EAT) is a structured therapeutic approach that uses interactions with horses (or donkeys) to support emotional, psychological, and behavioral healing. It is facilitated by licensed mental health professionals and is used to treat anxiety, depression, PTSD, trauma, and substance use disorders [1].

Unlike recreational horseback riding, equine therapy is a clinically guided process. Activities might include grooming, leading, and ground-based exercises, all designed to build trust, emotional regulation, self-awareness, and communication skills.

The horse responds directly to the client’s emotional and nervous system state, providing real-time non-verbal feedback that trained therapists use as a therapeutic tool. There are two primary forms used in addiction and mental health treatment [1]:

• Equine-Assisted Psychotherapy (EAP): Addresses emotional and psychological issues through structured, therapist-guided interactions with horses.
• Equine-Assisted Learning (EAL): Focuses on personal development and life skills through relationship-building activities with horses, such as building confidence, accountability, and emotional regulation.

How Does Equine Therapy Support Addiction and Mental Health Treatment?

Addiction and the mental health conditions that commonly co-occur with it, such as PTSD, anxiety, depression, and trauma, share a neurological dimension that talk therapy alone doesn’t always reach. Equine therapy works differently.

Horses are highly attuned to emotional states and respond immediately and honestly to what a person is projecting, without judgment, agenda, or the social complexity of human relationships. For someone whose trauma history has made trust difficult or whose addiction has been driven by emotional dysregulation they can’t articulate, working with a horse can access healing pathways that a therapy room can’t always replicate [2].

Research supports equine therapy’s effectiveness for reducing anxiety and PTSD symptoms, building emotional regulation skills, improving self-esteem, and increasing engagement in the broader treatment process. Anticipated outcomes include improved emotional regulation and reduced anxiety, enhanced self-esteem, and better coping strategies for addiction recovery [3].

At Holdfast Recovery, equine therapy is integrated into a broader treatment program for men, not offered as a standalone experience. It works alongside evidence-based clinical therapies as part of a whole-person approach to recovery.

Equine Therapy for Trauma and PTSD

Trauma doesn’t just live in memory. It lives in the nervous system, showing up as hypervigilance, emotional shutdown, and difficulty trusting others, patterns that are especially common among veterans, first responders, and men carrying childhood trauma [4][5].

Talk therapy asks a man to put those experiences into words. Equine therapy doesn’t require that as a starting point. Horses are prey animals, wired to read body language and nervous system cues with precision.

A man who appears calm but is internally on high alert will see that reflected back in how the horse responds to him. Learning to settle his own nervous system enough to earn the horse’s trust becomes a physical, repeatable practice in regulation, one that builds the foundation for deeper trauma work in EMDR and other clinical therapies [5].

Does Insurance Cover Equine Therapy?

It depends primarily on how and where the therapy is delivered.

• When insurance typically covers equine therapy: If you enroll at a facility where equine therapy is one of several therapeutic services, your insurance may cover the program as a whole, which indirectly includes the equine sessions. The key factors are whether the facility is accredited, whether inpatient treatment is deemed medically necessary, and how your particular health plan structures behavioral health coverage.
• Holdfast Recovery Coverage: In other words, if your insurance covers your residential or inpatient treatment at Holdfast Recovery, equine therapy is typically covered as part of the overall program rather than billed as a separate line item.
• When insurance typically does not cover equine therapy: It is rare for insurance to cover equine therapy as a standalone service outside of a full program. If you’re seeking equine therapy independently for general wellness, stress reduction, or personal development outside of a clinical treatment setting, most insurance plans will not cover it.
• Factors that affect coverage: The key factors are your plan type, the facility’s accreditation status, whether the overall treatment is deemed medically necessary, and how services are documented and billed. When licensed therapists use standard therapy CPT codes, many insurers will cover the service, provided that documentation and medical-necessity requirements are met.

How Holdfast Recovery Can Help You Verify Coverage

Insurance coverage for experiential therapies like equine therapy can be confusing to navigate alone, and the answer depends on your specific plan, carrier, and benefit structure. That’s why Holdfast Recovery’s admissions team verifies your benefits directly before you make any decisions.

Call our admissions team or submit your insurance information online. We contact your insurer directly, verify your behavioral health benefits, and confirm coverage for residential treatment, which includes equine therapy as part of the program. There is no cost to verify and no obligation to enroll. If your plan covers residential treatment, equine therapy comes with it.

Sources 

[1] Horse Therapy Canada. Equine Therapy vs Equine-Assisted Learning. 

[2] Souilm, N. (2023). Equine-assisted therapy effectiveness in improving emotion regulation, self-efficacy, and perceived self-esteem of patients suffering from substance use disorders. BMC Complementary Medicine and Therapies, 23.

[3] Kern-Godal, A., et al. (2015). Substance use disorder treatment retention and completion: A prospective study of horse-assisted therapy (HAT) for young adults. Addiction Science & Clinical Practice, 10.

[4] Fisher, P. W., et al. (2021). Equine-assisted therapy for posttraumatic stress disorder among military veterans: An open trial. The Journal of Clinical Psychiatry, 82(5).

[5] Malinowski, K. (2024). Ground-based adaptive horsemanship lessons for veterans with post-traumatic stress disorder: a randomized controlled pilot study. Frontiers in psychiatry, 15, 1390212.