My wait to surgery was almost 2 years. I was originally talking and planning about in late 2019. I was always going to be self pay b/s it is excluded from my health insurance policy, so I looked at practices and settled on one. Then, coronavirus hit. I also at that point realized the practice I was going to use was not the right one for me, and investigated a new one, doing a new consult virtually during coronavirus (Aug 20). This new practice had a lot more requirements even for self pay and while I was frustrated, in the end it was the best thing that happened. Now, what wasn't good in that time is I gained more weight (I blame it on the weight a lot of us gained during COVID but I just was in a weird place and under a lot of stress at work - quit that job!) but what was good is the program I went with was very intentional about preparing everyone - regardless of whether it was insurance covered or self pay - for what to expect after surgery.
Did it suck waiting? Yes. Do I regret it? Just a little - but mostly because I wish I had found this practice back in Fall 2019! I don't think I would have been as prepared and ready for surgery if I had rushed and gone with the practice I originally was looking at (they are well-known and have a strong reputation where I live, it just wasn't the right vibe). Part of why I feel like the past year has gone so smoothly for me (my surgery was Aug 16, 2021) is the level of mental preparation I had. I also used that time to unpack lots of other issues in therapy, which was helpful.
So all of this is to say... what do you think will give you the most success? Personally, I would try to do it through insurance if I had the chance. It's not just the surgery itself - but what if there are complications? It's rare, but possible, and I had so much stress and worry about how I could bankrupt us if something went wrong. I'd also use the time to try and build some good habits, which is something my program stressed during the education phase: drinking water, exercising, sleeping well, etc. If you think you have any emotional hang ups about food, it'd also be a great time to work on that, ahead of surgery.