When the game starts, each player is first dealt a hand of five cards with hands and feet for some reason, and six ability tiles. In addition to "draw one card from the opponent's hand," the ability tiles also contain special effects that are not found in the regular Old Maid, such as "increase the opponent's hand" and "discard your hand. The player must use this Ability Tile to eliminate his or her own hand, as in the Bubba Draw, in order to win.
One of the characteristics of an Ability Tile is that it has a fixed maximum number of tiles that can appear on the field. For example, one player can monopolize one Ability Tile, and while that player is monopolized, no other player can draw that Ability Tile until that player uses the Ability Tile they are monopolizing.
The game is characterized by the fact that both players can read each other's ability tiles as well as the opponent's hand, which creates a deeper gameplay than in ordinary Old Maid.