'Passing-by' patient or registered with a GP: what is the difference?

Quick answer. A passing-by patient (Dutch: passant) gets one-off care from a GP practice where they are not registered: on holiday, while visiting, or because their BSN and health insurance are not yet in place. The practice charges a nationally fixed passing-by rate per consultation. If you are registered, you are a regular patient: the GP receives a quarterly registration fee from your insurer, you pay nothing and GP care does not count towards your deductible, and you get the full package: medical record, repeat prescriptions, referrals, chronic care and mental health support (POH-GGZ). If you live in the Netherlands for more than a few months, registering is almost always the better option. At HeyDoc you can start as a passing-by patient and we convert you to a full registration as soon as your BSN and insurance are in place.

What is a passing-by patient?

Dutch primary care is built around registration: everyone has one GP who keeps the overview. A passing-by patient falls outside that system. You come with an acute or practical question to a practice that does not know you, the GP helps you with that one question and charges a passing-by rate. The Dutch Healthcare Authority (NZa) sets that rate every year; it depends on the length of the consultation and there is no registration fee on top, because you are not registered.

Typical passing-by patients are tourists, people staying with family, students still registered with their parents' GP, and newcomers waiting for their BSN or insurance.

What does being registered mean?

Once registered, the practice receives a registration fee from your health insurer every quarter, whether you visit or not. In return you get:

• a regular GP who knows and maintains your record;
• GP care without co-payment: consultations, chat, video and home visits are covered by Dutch basic insurance and do not count towards your deductible (lab tests, medication and hospital care do);
• repeat prescriptions without telling your story every time;
• referrals to a specialist, physiotherapist or mental health care, backed by your record;
• chronic care (POH-S), mental health support (POH-GGZ) and prevention;
• a practice with a duty of care: you can always come back, not just for that one question;
• the out-of-hours GP service (huisartsenpost) can view your record at night and in the weekend, with your consent.

As a passing-by patient you get little or none of this. You get good care for the question of the day, but no continuity.

Passing-by versus registered: the difference in one table

| | Passing-by | Registered | |---|---|---| | Your costs | NZa passing-by rate per consultation, paid directly or claimed back yourself | €0 for GP care under Dutch basic insurance; no deductible | | Medical record | Notes from that one visit | Full record; your previous file is requested | | Repeat prescriptions | Difficult, the GP does not know your medication | Request digitally, pharmacy of your choice | | Referrals | Possible, but without history | Via ZorgDomein, with your record | | Chronic care, POH-GGZ, prevention | No | Yes | | Out-of-hours service | Does not know you | Can view your record (with consent) | | Duty of care | Only for the acute question | Ongoing | | BSN required? | Not necessarily | Yes, for billing and your record |

When does passing-by care make sense?

• You are in the Netherlands temporarily (less than a few months) and your insurance from home covers medically necessary care (for example via the EHIC card).
• You have just moved and your BSN or insurance is not yet in place, but your medication is running out.
• You are registered elsewhere and are visiting Leiden.

In every other case, and certainly if you study or work here, registering is the normal route. It costs you nothing extra and gives you far more.

No BSN or insurance yet: how it works at HeyDoc

Dutch healthcare often treats the BSN as sacred, and partly for good reason: without it a practice cannot bill or safely exchange data. But that does not mean we cannot help you. This is how we do it:

1. No BSN yet, but a medical question? You come as a passing-by patient. We treat you as normal and you pay the passing-by rate.
2. Paying is done through a payment link: iDEAL or a Dutch bank account, or by credit card (American Express included). If you have an EHIC or travel insurance, you pay first and claim the amount back from your insurer with our invoice.
3. Aon Student Insurance? We bill Aon directly. You do nothing and never see an invoice.
4. BSN and insurance arrived? We convert your passing-by file into a full registration. Everything we already know about you stays in place; you do not have to tell your story again.

From the consulting room: the newcomer without a BSN

A pattern we see often: someone has just moved to Leiden, is not yet registered with the municipality, and has two weeks of blood pressure medication or contraception left. The previous GP is in another country or another city, and the pharmacy wants a Dutch prescription. Waiting for the BSN is not an option.

We see that person as a passing-by patient, check the medication, send the prescription to a pharmacy of their choice (we work closely with the Zuiderapotheek around the corner, but a prescription can go to any pharmacy in the Netherlands) and record what we did. A few weeks later the municipality letter with the BSN arrives, the insurance starts, and we convert the registration. The patient notices nothing, except that the invoices stop.

For students: do not rent a GP per consultation if you live here for a year

Some providers aimed at international students only help you as a passing-by patient: every question is a separate, paid appointment, and you are not registered as a regular patient anywhere. That can look convenient if you expect to rarely need a GP. In practice it works out differently:

• a contraception prescription, a new inhaler or a referral for your knee becomes a separate bill every time;
• nobody keeps your record, so at the out-of-hours service or the hospital you start from zero;
• mental health problems (and life is heavy enough these days) belong with the GP and the POH-GGZ, and you only get that care as a registered patient.

If you study in Leiden and have Dutch basic insurance or Aon Student Insurance, simply register. It costs you nothing and you have the same rights as every other resident. Read also how to register with a GP in the Netherlands and our page for international students in Leiden.

Frequently asked questions

What does a passing-by consultation cost? A nationally fixed NZa rate that depends on the length of the consultation. Ask the practice for the current amount before you come; with Dutch basic insurance the practice usually bills your insurer directly.

Does passing-by care count towards my deductible (eigen risico)? GP care never counts towards the deductible, not even as a passing-by patient. Medication and lab tests do.

Can I see a GP without a BSN? Yes, as a passing-by patient. A full registration does require a BSN; at HeyDoc we convert your passing-by file as soon as your BSN and insurance are in place.

Can I get a repeat prescription as a passing-by patient? Sometimes, if the GP can verify your medication (for example from the box, a prescription from your home country or your own record). Structural repeat prescriptions only work as a registered patient.

I am a student with Aon Student Insurance. Do I need to arrange anything? No. HeyDoc is contracted with Aon and bills directly. You register, and you never see an invoice.

Can I register with HeyDoc if I live elsewhere in Leiden? Yes. HeyDoc is the GP for all of Leiden and Leiderdorp.

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Written by Amir Mirrezai, GP at HeyDoc, Lammenschansweg 15B, Leiden. BIG 19917603001.