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 This is very in depth, can i use a voip phone with vpn and signal? Anyone tried that? And im curious, do any voip services accept bitcoin/lightning? 
 Yes you can use VoIP with VPN and signal.
Yes many providers accept Bitcoin.  Including JMP Chat, which we have 1 month free codes for, if you DM me I'll send you one.  Here's more info on how it works: simplifiedprivacy.com/voip 
 I've yet to find a website that lets you make regular phone calls (eg, to mobiles) whilst also paying with bitcoin and using a vpn

Anonymous use of the GSM network is tough.