If i pay cash for my surgery, will my HMO pay if I have complications later?

My insurance company covers the surgery, but it is very strict in their approvals. My problem is I need 6 months supervised diet and I don't have that. With a BMI of 41, if I follow a diet for 6 months I'll lose just enough weight not to qualify, then once I regain (like most of us do)I'll have to start the whole process over again. HMMM. Vicious cycle. I decided to pay cash for the surgery but I can't afford to pay for three additional surgeries should I have strictures of other complications! Worried that I won't be able to pay and be left without a resource for treatment. Is this is a bad idea? Help please. Thanks!

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