I’m in a similar situation: wife not expected to be around much longer, RMDs starting in a few years which are going to drive me into big IRMAA and Income Tax wallops. I went a different way: I just purchased an immediate fixed payout annuity with a 15 year payout guarantee, funded from an IRA. It will provide enough current income that together with SSI and another pension will cover all my ongoing expenses. Yes, I have to pay taxes on that current income, but they will start now and be spread out. I will still have a big IRMAA and Income Tax hit at age 73, but they will be reduced.