Annuity income can be received through formal annuitization or through income rider withdrawals. When you annuitize, the insurer converts your account value into a guaranteed income stream based on your age, gender, interest rates, and payout option — single life, joint life, or period certain. Modern contracts more commonly use income riders, which allow guaranteed lifetime withdrawals without formally annuitizing and without losing access to remaining account value, though riders have their own rules, caps, and costs.