The tax switch is the reason this matters. Before the annuity starting date, money taken out of a non-qualified annuity is treated as coming from earnings first. There is no basis recovery until the gain is exhausted, so early withdrawals from a contract that has grown are fully taxable, and potentially exposed to the 10% additional tax if the owner is under 59½. On and after the annuity starting date, section 72(b)(1) applies instead: gross income excludes the part of each payment that bears the same ratio to the payment as the investment in the contract, measured as of the annuity starting date, bears to the expected return under the contract, measured as of that same date. Each payment is then part tax-free return of your own money and part taxable income, in a fixed proportion. The proportion itself is the exclusion ratio, and its arithmetic belongs to that term. The point here is that annuitizing is what turns the switch, and that both inputs to the ratio are measured once, on the annuity starting date, and never re-measured.
Two consequences follow that people rarely anticipate. First, the tax-free portion is not unlimited: section 72(b)(2) caps the exclusion at the unrecovered investment in the contract, so once you have recovered your basis the payments become fully taxable for the rest of your life. Second, a workplace plan annuity is taxed differently. Section 72(d)(1) provides that for amounts received as an annuity under a qualified employer retirement plan, subsection (b) "shall not apply," and a separate Simplified Method recovers the investment instead. A pension annuity and a commercial annuity therefore reach similar answers by different routes, and figures quoted for one do not transfer to the other.
Partial annuitization exists and is widely overlooked. Since section 72(a)(2) took effect, if an amount is received as an annuity "for a period of 10 years or more or during one or more lives" under a portion of a contract, that portion "shall be treated as a separate contract," the investment in the contract is allocated pro rata between the annuitized and unannuitized portions, and "a separate annuity starting date ... shall be determined with respect to each portion." In plain terms: you can annuitize half the contract for lifetime income and leave the other half accumulating, with each half taxed on its own terms. The condition is that the annuitized portion must run for at least ten years or over one or more lifetimes; a short payout period does not qualify.
Irreversibility is the honest cost. Once a contract is annuitized, the balance has become a promise of payments and generally cannot be turned back into a lump sum, borrowed against, or left to heirs beyond whatever survivor or period-certain feature was chosen at the outset. Those features are priced: a guarantee that payments continue to a beneficiary lowers the payment. The settlement rates written into an older contract may be better or worse than what the same money would buy in the open market at the time you annuitize, and comparing the two before committing is the one piece of homework the decision genuinely rewards, because the choice cannot be revisited.