If it's an elective surgery which you have to go through several steps to get to that point(your only on lialda now so you'd have to try 6mp, remicade, humera ect ect) It has to be discussed in length because a total colectomy can cause problems with conceiving later in life.
If you have an emergency such as toxic megacolon, a rip/tear in the intestine, even some absesses and fistuleas can be emergency surgeries a hospital can not turn you away. If that happens you'll receive a bill up front unless you ask the check in nurse(they come around asking for emergency contact info, insurance info ect) if they have a hospital fund for people who don;t make very much money. Being on food stamps helps your case.